Board Review 2 – Case 17

Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.

More description and the answer (spoiler!) are seen below the video.

This case shows a CT with hyperdensity ventral to the pons and midbrain consistent with hemorrhage. Further imaging, including MRI and CT angiogram, were normal

The diagnosis is: benign perimesencephalic hemorrhage

This is a relatively benign form of subarachnoid hemorrhage of unknown etiology. The blood products are seen ventral to the pons, and are more common in younger patients. No vascular abnormality or tumor is found, and it is thought to be a result of disrupted veins, although the real cause is unknown. Outcomes are better compared to aneurysmal or traumatic subarachnoid hemorrhage.