22 year old with a known history of intracerebral aneurysms

Erin Zingarelli

Johns Hopkins Medical Institutions


Publication Date: 20130726


This 22 year old patient with a known history of intracerebral aneurysms presented after being "found down" with profound neurologic deficits on exam.

  1. Can you identify the pathology on this patient's non-contrast head CT?

    No pathology.

    Epidural hematoma

    Incorrect. An epidural hematoma classically has a convex appearance and is restricted by suture lines.

    Incorrect. While there is an abnormality on this scan, it is not a mass.
    Subarachnoid hemorrhage

    Correct. This patient's CT shows the classic "star sign," which indicates blood in the basal cisterns (a sign of a subarachnoid hemorrhage).
    Intraparenchymal hemorrhage

    Incorrect. While the patient may have bleeding within the parenchyma of the brain, it is not shown on this slice of the CT.

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