61-year-old woman with supratherapeutic INR now with acute mental status change. Parenchymal hemorrhage with layering blood products is present at the left posterior temporoparietal junction. The hemorrhage measures 3.4 x 3.0 cm in the axial plane (series 2 image 12). A rim of edema surrounds the hemorrhage. There is no underlying lesion evident by CT. There is mild mass effect upon the left lateral ventricle but no appreciable midline shift. The basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. Extensive soft tissue abnormality is present in the occipital region. This may represent sequela of prior soft tissue hemorrhage as seen on the MRI dated 1/17/2007.
Left temporoparietal junction parenchymal hemorrhage as detailed above. No underlying lesion is evident by CT -- MRI is recommended for further evaluation if clinically appropriate.