A 68-year-old man with a 10-year history of poorly controlled hypertension presents to the emergency department with sudden onset severe headache, nausea, and vomiting. On examination, he is alert but lethargic, with blood pressure 215/125 mmHg. Neurologic examination reveals no focal motor or sensory deficits, intact cranial nerves, and normal pupillary responses bilaterally. Non-contrast CT of the head demonstrates an acute hypertensive intracerebral hemorrhage in the left putamen measuring 4.5 cm in greatest dimension with 7 mm of midline shift. Which of the following ventricular structures is most vulnerable to compression from the mass effect of this hemorrhage?
- A)Left lateral ventricle only
- B)Interventricular foramen (foramen of Monro)
- C)Cerebral aqueduct (aqueduct of Sylvius)
- D)Third ventricleGABARITO
- E)Fourth ventricle
Explicação
The third ventricle is most at risk of compression from a left basal ganglia (putaminal) hemorrhage with midline shift. The putamen and globus pallidus are located medial to the lateral ventricle and lateral to the internal capsule. As the hematoma expands, it... Ver explicação completa e trilha adaptativa →