PMC5106536_01
36-year-old postpartum woman with phenylpropanolamine-induced intracerebral hemorrhage. Noncontrast CT scan shows acute intracerebral hemorrhage with adjacent subarachnoid and intraventricular hemorrhage.
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A non-contrast head CT revealed acute right basal ganglia and right frontal hemorrhage with adjacent subarachnoid and intraventricular hemorrhage (Fig. 1).
36-year-old postpartum woman with phenylpropanolamine-induced intracerebral hemorrhage. Arteriogram, arch injection, LAO 30 degree projection, shows luminal irregularities of the vertebral arteries.
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An urgent cerebral angiogram was negative for AVM or aneurysm, but showed luminal irregularities in vertebral arteries and middle cerebral arteries bilaterally, highly suggestive of vasculitis (Figure 2, Figure 3, Figure 4, Figure 5).
36-year-old postpartum woman with phenylpropanolamine-induced intracerebral hemorrhage. Arteriogram, right internal carotid injection, LAO 90 degree projection, shows luminal irregularities in the right MCA branches
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An urgent cerebral angiogram was negative for AVM or aneurysm, but showed luminal irregularities in vertebral arteries and middle cerebral arteries bilaterally, highly suggestive of vasculitis (Figure 2, Figure 3, Figure 4, Figure 5).
A. 36-year-old postpartum woman with phenylpropanolamine-induced intracerebral hemorrhage. Arteriogram, left common carotid injection. (A) LAO 90 degree projection shows intracranial luminal irregularities. (B) LAO 24 degree projection shows luminal irregularities of the left anterior circulation.
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An urgent cerebral angiogram was negative for AVM or aneurysm, but showed luminal irregularities in vertebral arteries and middle cerebral arteries bilaterally, highly suggestive of vasculitis (Figure 2, Figure 3, Figure 4, Figure 5).
36-year-old postpartum woman with phenylpropanolamine-induced intracerebral hemorrhage. Arteriogram, left vertebral injection, LAO 12 degree projection, shows multiple proximal luminal irregularities.
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An urgent cerebral angiogram was negative for AVM or aneurysm, but showed luminal irregularities in vertebral arteries and middle cerebral arteries bilaterally, highly suggestive of vasculitis (Figure 2, Figure 3, Figure 4, Figure 5).
36-year-old postpartum woman with phenylpropanolamine-induced intracerebral hemorrhage. Venous run-off from cerebral angiogram does not demonstrate filling defects.
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Venous run-off was completely normal (Fig. 6).