Sulaiman Iftikhar1, Nicholas Rossi2, Nitin Goyal1, Nickalus Khan2, Adam Arthur3, Ramin Zand1. 1. Department of Neurology, University of Tennessee Health Sciences Center, Memphis, TN, USA. 2. Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, TN, USA. 3. Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, TN, USA; Semmes-Murphey Clinic, Memphis, TN, USA.
Abstract
BACKGROUND: Magnetic resonance imaging (MRI) of the brain is highly sensitive for detecting intracerebral hemorrhage (ICH). Understanding of the imaging characteristics of hyperacute ICH is limited secondary to availability and increased time to scan relative to other imaging modalities. OBJECTIVE: In this report, we present the MRI characteristics of two patients who developed ICH while on the MRI table. METHODS: A 44-year-old women presented with week-long headache associated with blurry vision and photophobia. A second patient, a 38-year-old woman, presented with headache. Both patients developed ICH while on the MRI table. We studied the imaging characteristics of hyperacute ICH in these two patients. Postcontrast T1 sequence obtained showed contrast extravasation from two spots in the right caudate nucleus with ventricular extension. RESULTS: Hyperacute intracerebral hemorrhage has a characteristic appearance on MRI. The morphology of the hyperacute ICH that we presented confirms an asymmetric growth pattern. It also showed that the area of hemorrhage appeared to consist of multiple distinct compartments. These features suggested that expansion of ICH may be compounded by mechanical disruption of secondary blood vessels as the hematoma expanded. We can also confirm that hyperacute intraventricular hemorrhage can be revealed by gadolinium-enhanced MRI. CONCLUSION: MRI is able to detect hyperacute ICH and our findings demonstrate an asymmetric pattern of hematoma evolution. MRI with contrast is sensitive to detect hyperacute intraventricular hemorrhage.
BACKGROUND: Magnetic resonance imaging (MRI) of the brain is highly sensitive for detecting intracerebral hemorrhage (ICH). Understanding of the imaging characteristics of hyperacute ICH is limited secondary to availability and increased time to scan relative to other imaging modalities. OBJECTIVE: In this report, we present the MRI characteristics of two patients who developed ICH while on the MRI table. METHODS: A 44-year-old women presented with week-long headache associated with blurry vision and photophobia. A second patient, a 38-year-old woman, presented with headache. Both patients developed ICH while on the MRI table. We studied the imaging characteristics of hyperacute ICH in these two patients. Postcontrast T1 sequence obtained showed contrast extravasation from two spots in the right caudate nucleus with ventricular extension. RESULTS:Hyperacute intracerebral hemorrhage has a characteristic appearance on MRI. The morphology of the hyperacute ICH that we presented confirms an asymmetric growth pattern. It also showed that the area of hemorrhage appeared to consist of multiple distinct compartments. These features suggested that expansion of ICH may be compounded by mechanical disruption of secondary blood vessels as the hematoma expanded. We can also confirm that hyperacute intraventricular hemorrhage can be revealed by gadolinium-enhanced MRI. CONCLUSION: MRI is able to detect hyperacute ICH and our findings demonstrate an asymmetric pattern of hematoma evolution. MRI with contrast is sensitive to detect hyperacute intraventricular hemorrhage.
Authors: Brian L Edlow; Riley M Bove; Anand Viswanathan; Steven M Greenberg; Scott B Silverman Journal: Neurocrit Care Date: 2012-10 Impact factor: 3.210
Authors: Chelsea S Kidwell; Julio A Chalela; Jeffrey L Saver; Sidney Starkman; Michael D Hill; Andrew M Demchuk; John A Butman; Nicholas Patronas; Jeffry R Alger; Lawrence L Latour; Marie L Luby; Alison E Baird; Megan C Leary; Margaret Tremwel; Bruce Ovbiagele; Andre Fredieu; Shuichi Suzuki; J Pablo Villablanca; Stephen Davis; Billy Dunn; Jason W Todd; Mustapha A Ezzeddine; Joseph Haymore; John K Lynch; Lisa Davis; Steven Warach Journal: JAMA Date: 2004-10-20 Impact factor: 56.272