What CT finding confirms an acute intracerebral hemorrhage in the hyperacute stage?

• A. A hyperdense intraparenchymal hematoma on noncontrast CT.
• B. A hypodense area in brain parenchyma.
• C. No visible lesion on CT.
• D. Subarachnoid hyperdensity.

Answer: (A)

In the hyperacute stage, blood outside vessels is still fresh and highly attenuating on CT, so an acute intraparenchymal hemorrhage appears as a hyperdense (bright) area within the brain on noncontrast CT. This bright signal directly confirms acute bleeding, because normal brain tissue has a lower attenuation and early hemorrhage stands out as a dense lesion.

Context helps: as time passes, blood density changes—hematomas can become isodense with brain tissue or eventually hypodense as edema develops—so the bright, well-defined intraparenchymal hyperdensity is characteristic of an acute bleed on the initial scan.

Why the other patterns don’t fit: a hypodense area in the brain usually points to edema or an infarct rather than fresh blood; no visible lesion would miss an acute bleed entirely; subarachnoid hyperdensity indicates blood in the subarachnoid space, not within the brain tissue itself.