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CT head breakdown: dealing with basal ganglia haemorrhage

A male in his 50s presents to the Emergency Department with collapse. He undergoes a non contrast CT head. What are the findings and what is the most likely aetiology? ——————————- BASAL GANGLIA HAEMORRHAGE In this case we have obvious acute haemorrhage within the left basal ganglia. Remember we do NON contrast CT in cases of trauma and possible stroke as acute haemorrhage shows up as high density (ie bright) and the presence of bright IV contrast could mask the haemorrhage. Once we’ve seen the haemorrhage it is then a question about what is the aetiology: there are typical locations that we see in hypertensive haemorrhage with the basal ganglia (particularly the putamen) being one, others being the thalamus, pons and cerebellum. Doesn’t make it impossible that there isn’t an underlying mass that has bled but with a history of high blood pressure and a typical location/morphology, hypertensive haemorrhage becomes most likely. Remember to review the posterior aspects of the lateral ventricles on any CT head you’re looking at - layering blood could be the only abnormality on a scan and is easy to miss. Here we can see there is intraventricular extension 🔻@theradiologistpage Patient consent obtained —— #theradiologist #radiology #radiologist #physician #physicianassistant #medicine #medstudent #medicalstudent #medschool #medicalschool #radtech #whitecoat #mri #neurology #medical #neuroscience #radiologystudent #doctor #medicalstudents #interventionalradiology #neurosurgery #cthead #medic #frcr #anatomy #usmle #medlife #exams #mribrain