[Intracerebral hematoma associated with reduced apparent diffusion coefficient mimicking acute stroke].
We report the case of a 67 year old patient admitted at our institution for acute onset of left hemiplegia. MRI was done 2 h 30 after symptom onset. Diffusion weighted images showed a hyperintense lesion in the right basal ganglia region with restricted apparent diffusion coefficient (ADC=428. 10(-6) mm(2)/s), a 50% decrease in value compared to the normal left side, consistent with acute ischemia. The lesion was hyperintense and moderately heterogeneous at FLAIR imaging, best seen on echo planar T2W images, with hypointense rim consistent with magnetic susceptibility artifact. The appearance and location of the lesion suggested the possibility of hematoma, which was confirmed at CT. Interpretation of ADC values must be performed in correlation with results at imaging including sequences sensitive to magnetic susceptibility artifacts such as echo planar T2*W and T2W sequences in order to exclude the possibility of underlying hematoma.
Randoux
B
B
Service de Neuroradiologie, Groupe hospitalier Pitié-Salpêtrière, Paris. bruno.randoux@caramail.com
Marro
B
B
Dormont
D
D
Samson
Y
Y
Marsault
C
C
D000208:Acute Disease; D000368:Aged; D002545:Brain Ischemia / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000473:pathology*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D006406:Hematoma / Q000473:pathology*; D006801:Humans; D008297:Male