Enunciado Female, 13 yo, had sudden signs of headache, nausea, vomit and fever 3 days prior. It evolved with signs of meningeal irritation and was taken to the PA two days after the clinical signs, where antibiotic therapy (ceftriaxone and acyclovir) was started empirically. She was transferred to the Emergency Department and an image test (brain computed tomography - Image 1) was requested. It showed lesion compatible with hemorrhagic encephalic stroke (hES) in knee topography of the corpus callosum. (1) Computed tomography of the brain, without intravenous injection of iodinated contrast, axial cut, internal capsule level and core of the base. (2) Cerebral arteriography from the internal carotid artery, seen in profile. (3) 3D angio-MRI (time-of-flight) (3D TOF), which promotes contrast between vascular structures with flow and stationary tissue, in a single acquisition. Question:Based on the clinical history and images provided, what is the most likely diagnosis? Ruptured pericallosal artery aneurysm Arteriovenous malformation (AVM) Cavernoma Brain capillary telangectasias Questão de Prova (HC-FMUSP) Hemorrhagic Vascular Brain Accident is a medical emergency and its diagnosis should be performed as soon as possible. What is the most appropriate test to define the diagnosis? Magnetic Resonance Electroencephalogram Electroneuromyography Videoelectroencephalography Computed tomography Time is Up! Time's up
