Concluded Case

Hypertensive Lobar Hematoma Rt Temporal

New Case 68 yr,F ,Kniwn hypertensive and DM on ,regular check up ,developed acute onset of Left sided weakness on 18th April at 3 PM while watching Television news. Immediatly felt mild head ache rt side with out vomiting. On exam conscious BP 160/ 90 mmhg ( on regular Losartan 50 mg ) No field deficit. Left sided hemiparesis with gr 3/ 5 power with hyperactive DTRS with extensor plantar on the left with intact sensations. What abnormality in the MRI ?

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Concluded answer
Thanks Curofy ,Dr Prashant and Dr Krishnenendu. Discussion what abnormality in the MRI. * Parenchymal hematoma rt temporal lobe( involving the cortex ,subcortical white matter,extending to parietal periventricular white matter). * Mild midlihe shift 5.2 mm to left. *Minimal SAH noted along the rt parietotemporal and superior frontal sulci. * Brainstem ,thalamus and basal ganglia shows normal signals. * Normal venogram.
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Thanks Curofy
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Thanks Curofy ,Dr Prashant and Dr Krishnenendu. Discussion what abnormality in the MRI. * Parenchymal hematoma rt temporal lobe( involving the cortex ,subcortical white matter,extending to parietal periventricular white matter). * Mild midlihe shift 5.2 mm to left. *Minimal SAH noted along the rt parietotemporal and superior frontal sulci. * Brainstem ,thalamus and basal ganglia shows normal signals. * Normal venogram.
Appears to be a vascular event with Haemorrhagic infarct but not in a particular vascular territory,would think of sinus thrombosis.
Valuable opinion
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Superior saggital sinus and left transverse sinus thrombosis with hemorrhagic infarct in right MCA territory

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