The massive intraparenchymal hemorrhage depicted in the autopsy specimen of a 60-year-old male patient is the result of hypertensive vasculopathy. Bleeding originated in penetrating vessels of the basal ganglia and extended into adjacent cerebral structures. The blood acts as a space-occupying lesion, resulting in uncal and subfalcine herniation with associated tissue destruction.
MRI of Glioblastoma with Subfalcine Herniation
This elderly patient complaining of headache was diagnosed with glioblastoma following biopsy of the heterogeneous, ring-enhancing lesion in the right temporal lobe. Mass effect caused by the space-occupying tumor has pushed the ipsilateral cingulate gyrus under the falx cerebri, resulting in a subfalcine herniation.