PMC6304919_01
Contrast-enhanced cranial CT demonstrating a hemorrhagic focus in the right parietal and occipital lobes with possible secondary bilateral infarction due to compression of posterior circulation vessels, subfalcine herniation, beginning uncal herniation, and cerebral edema.
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Contrast-enhanced cranial CT scan revealed acute parenchymal hemorrhage on the right occipital lobe amounting to 18.4 cc, with extension to the right parietal lobe, surrounding cerebral edema, subfalcine herniation, and beginning uncal herniation (Figure 1).
Plain cranial CT demonstrating a decrease in previously noted cerebral edema and midline shift.
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A repeat CT scan five days postictus revealed decreased cerebral edema especially on the left hemisphere and a relative decrease in midline shift (Figure 2).
Plain cranial MRI images of the patient. (a) T1-weighted MR image demonstrating a hyperintense hematoma with hypointense core on the right occipital lobe, compressing the occipital horn of the right lateral ventricle, (b) T2-weighted MR image showing hyperintense signals of the same hematoma with surrounding vasogenic edema, and (c) FLAIR MR images demonstrating cortical-subcortical signal abnormalities on the right as well as left occipital lobes.
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Cranial MRI (done without contrast due to financial constraints) at seven days postictus revealed a 4.6 x 4.3 x 2.5 cm parenchymal hematoma in the right parietooccipital area with a volume of 26 cc, compressing the occipital horn of the right lateral ventricle (Figure 3).