MRI in acute subarachnoid haemorrhage; findings with a standardised stroke protocol.
There is doubt as to whether acute haemorrhage is visible on MRI. We carried out MRI within 6 h of symptom onset on five patients with minor (low Hunt and Hess grades 1 or 2) subarachnoid haemorrhage (SAH) diagnosed by CT to search for any specific pattern. We used our standard stroke MRI protocol, including multiecho proton density (PD)- and T2-weighted images, echoplanar (EPI) diffusion- (DWI) and perfusion- (PWI) weighted imaging, and MRA. In all cases SAH was clearly visible on PD-weighted images with a short TE. In four patients it caused a low-signal rim on the T2*-weighted source images of PWI, and DWI revealed high signal in SAH. In the fifth patient SAH was perimesencephalic; susceptibility effects from the skull base made it impossible to detect SAH on EPI DWI and T2*-weighted images. Perfusion maps were normal in all cases. MRA and conventional angiography revealed an aneurysm in only one patient. Stroke MRI within 6 h of SAH thus shows a characteristic pattern.
Fiebach
J B
JB
Division of Neuroradiology, Department of Neurology, University of Heidelberg Medical Centre, Im Neuenheimer Feld 400, 69120, Germany. Jochen_Fiebach@med.uni-heidelberg.de
Schellinger
P D
PD
Geletneky
K
K
Wilde
P
P
Meyer
M
M
Hacke
W
W
Sartor
K
K
D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D019291:Skull Base; D020521:Stroke / Q000473:pathology*; D013345:Subarachnoid Hemorrhage / Q000473:pathology*