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Chapter: Neuro

Subchapter: Head (Read entire chapter)

Diagnosis: Parenchymal hemorrhage with intraventricular extension
Noncontrast head CT shows an area of acute hemorrhage in the left occipital lobe (asterisk). There is mild edema (black arrows) with mild mass-effect surrounding the hemorrhage, without causing significant midline shift. Layering blood is also seen in the atrium of the left ventricle and posterior horn of the right ventricle, as well as blood in posterior falx and tentorium (white arrows). The ventricles are mildly dilated, which could suggest early trapping. Secondary intraventricular hemorrhage (IVH) may occur in one third to one half of patients with spontaneous ICH as a result of arterial hypertension and/or small arteriolar degeneration. IVH is seen most often with thalamic, putaminal, or caudate nucleus hemorrhages, which can extend medially a short distance directly into the lateral or third ventricles.

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