CT Hemorrhagic stroke

October 30, 2013

CNS, CT, Head, Non-Trauma

Young patient presented with altered mental status, concern for drug use per EMS.  The patient had some response to naloxone but didn’t return to normal orientation.  On exam there was a subtle left gaze preference with a blood pressure of 280/160 mmHg.  The patient’s head CT non-contrast:


This head CT shows a large hemorrhagic stroke with 8mm of midline shift.  It also showed left uncal herniation on other cuts. 

This is an unfortunate complication to stimulant drug use, most commonly implicated are cocaine and methamphetamines.  One of the many reasons not to do drugs!

Author:  Russell Jones, MD

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EMREMS: Radiology in Emergency Medicine

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