Patient presents with acute right sided weakness and headache. The patient's blood pressure in the ED at presentation was 200/110.
Stroke
Based on the right sided weakness findings are most concerning for a left middle cerebral artery territory lesion.
Non Contrast Head CT:
There is a large hyperdense hemorrhage centered within the left basal ganglia with extension into the adjacent left frontal lobe and lateral ventricles.
There is associate hydrocephalus, left to right midline shift, mass effect on the ventricular system.
Based on the extent of hemorrhage and the patient's comorbidities, the patient's family chose to pursue comfort care.
Hypertensive hemorrhage.
Hypertension is the most common cause of nontraumatic hemorrhage in adults. Hypertensive hemorrhages, both large and small, most commonly occur in the deep gray matter, such as the basal ganglia or thalami, or the brainstem.