Case 231

Case 231

Medical History

58 years old, female, patient attended the emergency room reporting sudden discomfort and loss of strength in the lower limbs followed by a fall from her own height. She reports chronic arterial hypertension, dyslipidaemia and thrombophilia (deficiency of antithrombin III). She uses Losartan and aspirin. Physical exam: good general state, vigilant, oriented in time and space, afebrile, hypertensive (180;110mmHg), absence of meningeal signs, left hemiplegia with hyperreflexia and plantar reflex indifferent to the left. It was requested a computed tomography (CT) of the cranium without contrast, a magnetic resonance (MRI) and an angioresonance of the cranium.

Image 1: Cranial computed tomography (CT) without contrast, axial plane.


Image 2: T1-weighted magnetic resonance (MRI) image of the cranium, sagittal plane, after the contrast.


Image 3: cranial angioressonance, venous phase, axial and sagittal plane. 

Based on the clinical history and in the imaging studies presented, it is possible to conclude that the cause of the lesion was: