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Intracerebral Hemorrhage from Anticoagulation

A 77 year old man was on intravenous heparin for DVT. His PTT was 127 when he developed paralysis of the right arm followed by headache and obtundation.

Outline the Hemorrhage          Note the "Fluid-Fluid" Levels          Note the Midline Shift

Axial Head CT: Note the multiple intracerebral hemorrahge in the left hemisphere. Several have fluid-fluid levels where the cells in the blood have layered below the plasma.

Revised 05/04/06.
The Electronic Curriculum is copyrighted 1998,  Case Western Reserve University School of Medicine.