PMC4010061_01
Sagittal view of the lumbar spine on CT reveals a calcified L2-L3 disc bulge with narrowing of the intervertebral disc space.
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A CT scan of the lumbar spine, performed on admission, revealed multilevel disc changes at the levels of L1-2, L2-3, and L5-S1 (Figure 1).
CT of the head, performed within 30 minutes of presentation, reveals a large intraparenchymal hemorrhage in the right cerebral hemisphere involving the right parietotemporal lobes. There is transfalcine herniation and a right to left midline shift measuring 1.9 cm.
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Subfalcine and right uncal herniation were present (Figure 2).
CT of the head immediately after a right sided craniotomy was performed.
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The patient was taken to the operating room for an emergent frontotemporal craniectomy with duraplasty (Figure 3).
Carotid Cerebral Angiogram (Right Internal Carotid Artery injection, lateral view) revealing a 3 x 3 mm aneurysm on a distal angular MCA branch.
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The angiogram revealed a solitary mycotic aneurysm in a distal segment of the right middle cerebral artery (Figure 4).