Case of the Week # 337

Nguyen Ha, MD

Answer

Case report:

A 30-year-old woman (G1P0), with unremarkable family history, presented to our unit at 36 weeks of her pregnancy. She did not undergo any previous screening tests. Our examination revealed unilateral hypoechoic inhomogeneous mass within cerebral parenchyma. Our initial diagnosis was teratoma, but repeated exam after four days showed structural changes and different echogenicity of the mass and so our final diagnosis was cerebral hemorrhage. The findings were confirmed by MRI scan.

Figure 1-7: 36 wekks of pregnancy.

Figure 8-15: 4 days later; image 1-4 suggesting a middle cerebral artery infarction with formation of schizencephaly, no more cortex at the level of the insula.