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Thalamic Intracerebral Hemorrhage - Ventricular Extension - Case 2

A 52 year-old hypertensive man developed a headache, nausea and vomiting, associated with right sided numbness which slowly worsened 30 minutes. He then developed right sided weakness followed by a decreased level of alertness.

Outline the Thalamic Blood         Outine the Intraventricular Blood

Thalamic Intracerebral Hemorrhage with Ventricular Extension: Axial CT scans. Note that there is a large hemorrhage in the region of the left thalamus with extension to the lateral ventricle.

This is one of the common sites of hypertensive intracerebral hemorrhage. Early neurological symptoms include contralateral sensory loss. With mass effect, patients develop headache, nausea and vomiting. As the lesion expands, patients may become lethargic due to direct compression on the upper brainstem structures or obstructive hydrocephalus. Eye movement abnormalities, especially impaired vertical gaze, are common in thalamic mass lesions.


Revised 11/15/06.
Copyrighted 2006. David C Preston