Case Report

Isolated Central Sulcus Hemorrhage: A Rare Presentation Most Frequently Associated with Cerebral Amyloid Angiopathy

Figure 4

Second case of isolated central sulcus hemorrhage. MR images in a 67-year-old female with history of nasal cavity lymphoma presenting with right sided weakness. There is no history of trauma, hypertension, or bleeding diathesis. Flair MRI (image (a)) demonstrates isolated increased signal within the left central sulcus with corresponding loss of signal on gradient echo (image (b)) consistent with isolated central sulcus hemorrhage. Nonspecific white matter changes are seen on the FLAIR sequence (image (c)). MR angiogram did not demonstrate any aneurysms or vascular malformations. A probable diagnosis of cerebral amyloidosis was made based on the Boston criteria. Follow up MR images demonstrated interval resolution of the acute hemorrhage with chronic cortical and subcortical changes on the gradient echo sequences (image (d)).
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(d)