Spontaneous Parenchymal Haemorrhage

Intra-cerebral haemorrhage causing obstructive hydrocephalus

The first non-contrast CT shown here (Figure 1) is from a patient with large left-sided cerebellar haemorrhage  with intra-ventricular extension . The haemorrhage is causing significant mass effect on the 4th ventricle   (resulting in obstructive hydrocephalus ) as well as the pons . The Neurosurgical team was consulted urgently and the patient was operated (Figures 7 to 12). A craniectomy was performed to relieve the intracranial pressure  (a skull defect could be seen) (Figures 2 to 6), the cerebellar haematoma was extracted and an intra-ventricular drain was inserted  (Figure 12).