UMEM Educational Pearls


40 year-old male with severe uncontrolled hypertension presents with altered mental status. Head CT is shown here. Name three common anatomic locations generally seen for non-traumatic intracerebral hemorrhage. 



Answer: The most common anatomic sites for intra-cerebral hemorrhage are:

  1. Basal ganglia (40-50%)
  2. Intralobar (20-50%)
  3. Thalamus (10-15%)
  4. Pons (5-12%)
  5. Cerebellum (5-10%), 

...and, don't forget the most common causes of non-traumatic intra-cerebral hemorrhage: 

  • Systemic hypertension (essential, drug use, ecclampsia)
  • Rupture of arteriovenous malformation or aneurysm 
  • Arterial disease (e.g., cerebral amyloid angiopathy)
  • Congenital or acquired coagulopathy
  • CNS tumor with necrosis and hemorrhagic conversion


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