CT pre-contrast

Diagnosis: Hemorrhagic melanoma metastasis

Lung, breast, melanoma and GI are the most common sources of intraparenchymal brain metastases. 80% of metastases are multiple and represent up to 1/3 of all brain tumors. The most common location for intraparenchymal metastases is at the grey white junction. Metastases which tend to bleed are thyroid, renal cell, melanoma and choriocarcinoma. Even though lung and breast don't bleed as frequently as these tumors, their much higher incidence makes them strong considerations for any hemorrhagic metastasis. Other causes of intracerebral lobar hematoma include hypertension, amyloid angiopathy, underlying AVM or aneurysm, cocaine abuse, coagulopathies, and hemorrhagic infarction. Most hypertensive hemorrhages occur in the basal ganglia; however, a significant minority may be lobar. Hemorrhage due to amyloid angiopathy is classically lobar and may be multiple. Those patients are usually elderly, normotensive, and demented. AVM and aneurysm are also important considerations as etiologies for intracerebral hematoma. Related Cases

HTN Hemorrhage Aneurysm Hemorrhage Bifrontal hemorrhage