Neuroanatomy Atlas in Clinical Context

76 CHAPTER 4 / HEMORRHAGE INTO THE BRAIN: INTRACEREBRAL HEMORRHAGE

A

B

Skull

C

Blood in frontal lobe

Skull

Blood in third ventricle

Temporal horn

Blood in cerebral aqueduct

4-16 The presence of blood within the substance of the brain may be called parenchymatous hemorrhage (a more general and global term), or cerebral hemorrhage (blood into the cerebral hemi sphere), brainstem hemorrhage (blood into the brainstem), pontine hem orrhage (blood into the pons), or by any of a number of other terms that indicate a more specific location and size ( Duret hemorrhage ), shape ( splinter hemorrhage ), or extent of the extravasated blood. The large hemorrhages into the hemisphere ( A , B ) have resulted in enlargement of the ventricles, a midline shift (with the real possibility of brain hernia tion), and, in the case of A , a small amount of blood in the right posterior horn of the lateral ventricle. In these examples, the lesion is most likely a result of hemorrhage from lenticulostriate branches of the M 1 segment .

Blood in the substance of the brain and in the ventricular system may also result from trauma ( C ). In this example ( C ), blood is located in the frontal lobe, the third ventricle, and cerebral aqueduct . The enlarged temporal horns ( C ) of the lateral ventricles are consistent with the inter ruption of CSF flow through the cerebral aqueduct ( noncommunicating hydrocephalus ). Images A – C are CT. Other causes of blood within the brain include bleeding from a vari ety of tumors, more commonly from malignant tumors and metastatic tumors and less so from benign tumors. Traumatic injury, commonly referred to as traumatic brain injury ( TBI ), may be a source of blood within the brain as well as the transformation of an ischemic stroke into a hemorrhagic stroke . Copyright © Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. 2024

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