Intraparenchymal Hemorrhage

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Presentation transcript:

Intraparenchymal Hemorrhage

Duret Hemorrhages

Intraventricular Hemorrhage & The Burst Lobe Syndrome

Intraventricular Hemorrhages

H. Okazaki and B. W. Scheithuer H. Okazaki and B. W. Scheithuer. Atlas of Neuropathology, New York:Gower Medical Publishing, 1988.

A 57-Year-Old Male found unconscious

Burst Lobe Syndrome

A 52-Year-Old Male with a closed head injury

Eschbach collection: head trauma

A 71-year-old man was pushed onto his back by a slow-moving vehicle A 71-year-old man was pushed onto his back by a slow-moving vehicle. Initially, he was alert and fully oriented. In the emergency department, the patient was disoriented to place; the examination revealed no signs of injury, and coagulation studies were normal. Within 30 minutes after the initial evaluation, his neurologic status deteriorated. The axial section of a computed tomographic (CT) scan of the head, obtained without the addition of contrast medium, revealed four types of acute post-traumatic intracranial hemorrhage: an epidural hematoma (thick white arrow) and a squamous temporal fracture (which is not shown) on the left side, a laminated subdural hematoma (thick black arrow) on the right side, right-sided periventricular and frontal-lobe contusions containing an intraparenchymal hematoma (thin white arrow), and a subarachnoid hemorrhage (thin black arrow) in the right frontal region. Despite emergency surgical decompression, the patient died five days after the accident. The site of acute post-traumatic intracranial hemorrhage, the type of vessel injured, and the architecture of the tissue all influence the appearance of extravascular blood on CT scans. Epidural hemorrhages are frequently caused by laceration of meningeal arteries, often in association with skull fractures. Epidural blood can dissect the dura from the skull and cause lenticular hematomas that appear hyperdense on CT scanning and that span dural attachments between suture lines. Subdural hematomas are formed when blood is extravasated into the subdural space between the arachnoid and the pia mater. Subdural hematomas surround the brain, forming crescent-shaped hyperdense areas on CT scanning that can interdigitate with the gyri of the cortex along the periphery of a hemisphere. Disruption of the intraparenchymal capillaries as the result of a contusion is indicated by an area of intermediate density on CT scanning. An intraparenchymal hemorrhage that displaces surrounding brain tissue appears as a frankly hyperdense area on CT scanning with a hypodense (edematous) periphery. Trauma is the most common cause of subarachnoid hemorrhage, which appears in the subarachnoid space.