An unusual site of intracerebral haemorrhage: microbleeds in perspective!

Abstract

A 66-year-old lady with a background history of hypertension and non-insulin-dependent diabetes was admitted with an episode of confusion and slurred speech and was found to have small foci of restricted diffusion in the deep white matter of the left posterior frontal lobe in keeping with small embolic acute infarcts (Figure 1). As a part of her stroke work up, she was found to have a left ventricular thrombus in spite of preserved left ventricular systolic function. The cause of this thrombus remained uncertain and a targeted work up did not reveal any clear precipitant. She was initially commenced on warfarin anticoagulation that was subsequently switched to low molecular weight heparin due to poor international normalized ratio control. Figure 1. Multiple embolic infarcts on MRI. She presented 2 months later with symptoms of headache and confusion and was found to have a small subdural haematoma in the right parietal region (Figure 2). There was no preceding trauma or local injury. After a thorough …