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Unusual presentation of more common disease/injury
CASE REPORT
Rapidly expanding venous intracerebral haemorrhage with spot sign
  1. Clark Funnell1,
  2. Manraj K S Heran2,
  3. Philip Teal1,
  4. Thalia Field1
  1. 1Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Clark Funnell, clark.funnell{at}alumni.ubc.ca

Summary

A 79-year-old woman was brought to the hospital with an acute-onset left haemiparesis. On initial examination, she had a pure sensorimotor syndrome with left-sided weakness and sensory disturbance. Her mental status was normal. She had normal visual fields to confrontation and no neglect. Her initial CT and CT angiogram revealed cerebral venous thrombosis with associated haemorrhage. A ‘spot sign’ was visible on CT angiogram. Immediately following the CT scan, the patient had a rapidly progressive decline in level of consciousness, requiring endotracheal intubation. A follow-up CT scan 70 min later showed the haemorrhage had expanded dramatically, with mass effect, midline shift and herniation. After a discussion with the family, the patient was extubated and died the following day. This is the first case of a cerebral venous thrombosis with associated spot sign-positive haemorrhage and published clinical details that the authors are aware of.

  • neurology
  • stroke
  • haematology (incl blood transfusion)

https://doi.org/10.1136/bcr-2017-223055

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    Footnotes

    • Contributors CF was involved in the clinical care of the patient and wrote the manuscript. MKSH edited the manuscript and provided radiological images and captions. PT was involved in the care of the patient and reviewed the manuscript. TF edited the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.