Neuroradiology Teaching File

Parenchymal Hemorrhage

Findings: Large intraaxial high attenuation abnormality in the right parietal lobe. There is mass effect with effacement of the right lateral ventricle and of the sulci in the right cerebral hemisphere. The left lateral ventricle is dilated. There is midline shift to the left.

The most common cause of nontraumatic intracranial hemorrhage is hypertension. The penetrating branches of the middle and the basilar arteries are commonly affected. Therefore, hemorrhage in the external capsule, putamen, thalamus and pons is seen. Hemorrhage in the lobar white matter occurs 15 to 20% of the time.

Teaching Point: The left lateral ventricle is dilated secondary to occlusion of the foramen of Monro.

Case Prepared by Steven Lee, M.D. and Anthony L. Alcantara, M.D.

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