MRI profile of the perihematomal region in acute intracerebral hemorrhage.
OBJECTIVE
The pathophysiology of the presumed perihematomal edema immediately surrounding an acute intracerebral hemorrhage is poorly understood, and its composition may influence clinical outcome. Method-Twenty-three patients from the Diagnostic Accuracy of MRI in Spontaneous intracerebral Hemorrhage (DASH) study were prospectively enrolled and studied with MRI. Perfusion-weighted imaging, diffusion-weighted imaging, and fluid-attenuated inversion recovery sequences were coregistered. TMax (the time when the residue function reaches its maximum) and apparent diffusion coefficient values in the presumed perihematomal edema regions of interest were compared with contralateral mirror and remote ipsilateral hemispheric regions of interest.


RESULTS
Compared with mirror and ipsilateral hemispheric regions of interest, TMax (the time when the residue function reaches its maximum) and apparent diffusion coefficient were consistently increased in the presumed perihematomal edema. Two thirds of the patients also exhibited patchy regions of restricted diffusion in the presumed perihematomal edema.


CONCLUSIONS
The MRI profile of the presumed perihematomal edema in acute intracerebral hemorrhage exhibits delayed perfusion and increased diffusivity mixed with areas of reduced diffusion.
Olivot
Jean-Marc
JM
Department of Neurology and Neurological Sciences, Stanford Stroke Center, Stanford University Medical Center, Palo Alto, CA 94304, USA.
Mlynash
Michael
M
Kleinman
Jonathan T
JT
Straka
Matus
M
Venkatasubramanian
Chitra
C
Bammer
Roland
R
Moseley
Michael E
ME
Albers
Gregory W
GW
Wijman
Christine A C
CA
D000328:Adult; D000368:Aged; D001929:Brain Edema / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D006406:Hematoma / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors