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Images in Neurology |

Ring Enhancement After Hemorrhagic Stroke

A. A. Wong, MBBS; R. D. Henderson, MBBS, FRACP; J. D. O'Sullivan, MBBS, MD, FRACP; S. J. Read, MBBS, PhD, FRACP; T. Rajah, MBChB, FRACR
Arch Neurol. 2004;61(11):1790. doi:10.1001/archneur.61.11.1790.
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A 65-year-old woman experienced an acute onset of expressive dysphasia 48 hours after a left carotid endarterectomy. A computed tomographic (CT) head scan revealed a 35-cm3left frontal hematoma (Figure, A). The patient improved with conservative management. A CT scan performed 9 weeks later demonstrated hypodensity with ring enhancement postcontrast (Figure, B and C). Subsequent magnetic resonance imaging findings of negative mass effect and uniform hemosiderin staining weighed against an associated tumor or abscess1 (Figure, D).

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A, Initial computed tomographic scan demonstrating left frontal hematoma. Precontrast (B) and postcontrast computed tomographic scan (C) 9 weeks later showing a ring-enhancing lesion. D, T2 magnetic resonance image demonstrating negative mass effect.

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