Magnetic Resonance Imaging Characteristics of Hyperacute Intracerebral Hemorrhage

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.