Bất kỳ thử nghiệm cần thiết cho một bệnh nhân nên được đặt hàng với sự hợp lý kỳ vọng rằng nó sẽ mang lại lợi ích, chẳng hạn như một sự thay đổi trong thời gian hoặc lựa chọn của một kỹ thuật tối ưu hóa trước tác thích hợp, vượt quá bất kỳ tác dụng phụ tiềm năng. | CT head Question 5 72-year-old female. Past history of poorly controlled hypertension. Collapsed at home Fig. . What is the diagnosis What are the common causes 5 Fig. Quiz case. Answer Intracerebral haematoma There is a brain stem intracerebral haematoma causing hydrocephalus from ventricular obstruction at the level of the IV ventricle and aqueduct. Common causes Hypertension external capsule basal ganglia pons thalamus see Fig. cerebellum Trauma Aneurysm 232 Arteriovenous malformation Case illustrations Fig. Thalamic haemorrhage. 5 Fig. Frontal haemorrhage. The patient was anticoagulated with warfarin. Anticoagulation see Fig. Haemorrhagic infarction see Fig. . Comment The acute haematoma is normally rounded homogeneous and hyperdense. With clot retraction a surrounding rim of low-density oedema appears. A non-contrast-enhanced CT scan is always performed if intracerebral 233 CT head Fig. Haemorrhagic infarct in the left middle cerebral artery territory. Note how the acute blood is limited to the middle cerebral artery territory. 5 haemorrhage is suspected. Otherwise it is not possible to distinguish acute blood from avid contrast enhancement . an avidly enhancing tumour . Mass effect is often negligible and less than a tumour of a similar size. The haematoma can rupture into the ventriclular system and then cause hydrocephalus. Over a period of 1-2 weeks the haematoma decreases in density starting in the periphery and working centrally. At this stage contrast enhancement occurs peripherally due to formation of hypervascular granulation tissue. Intracerebral haemorrhage is less common than infarction and a history of hypertension must be sought. Spontaneous rupture of the lenticulostriate arteries are frequently the cause and this explains why the basal ganglia are a common site. .
