Intracranial hemorrhage MRI

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Intracranial hemorrhage Microchapters

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Overview

Classification

Intra-Axial Hemorrhage
Extra-Axial Hemorrhage

Pathophysiology

Causes

Differentiating Intracranial Hemorrhage from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

MRI

Subarachnoid Hemorrhage

  • Fluid-attenuated inversion recovery (FLAIR) is the most sensitive MRI pulse sequence for the detection of SAH. SAH appears as high-intensity signal in normally low signal CSF spaces.
  • T2- and T2*-weighted images can potentially demonstrate SAH as low signal intensity in normally high-signal subarachnoid spaces.
  • On T1-weighted images, acute SAH may appear as intermediate- or high-intensity signal in the subarachnoid space.
  • MR angiography may be useful in the evaluation of aneurysms and other vascular lesions that cause SAH.

Subdural Hemorrhage

  • MRI is more sensitive than CT scanning in the detection of subdural hematomas because the multiplanar and superior tissue differentiation of MRI makes detection easier.
  • The shape of the subdural hematoma on axial images is the same crescent-shaped pattern seen on CT scan images.
  • The signal depends on the age of the hemorrhage and follows the signal pattern of intraparenchymal hematomas in acute and subacute cases.
  • Chronic subdural hematomas, which appear as isoattenuation relative to CSF on CT scans, often demonstrate increased signal intensity on T1-weighted images because of the presence of free methemoglobin, though the intensity decreases over time.

References



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