title: MRI Detection of Cerebral Infarction in Subarachnoid Hemorrhage.
abstract: To investigate magnetic resonance imaging (MRI) detection of cerebral infarction (CI) in patients presenting with subarachnoid hemorrhage (SAH).
  
  
  
  CI is a well-known complication of SAH that is typically detected on computed tomography (CT). MRI has improved sensitivity for acute CI over CT, particularly with multiple, small, or asymptomatic lesions.
  
  
  
  With IRB approval, 400 consecutive SAH patients admitted to our institution from August 2006 to March 2011 were retrospectively reviewed. Traumatic SAH and secondary SAH were excluded. Data were collected on demographics, cause of SAH, Hunt Hess and World Federation of Neurosurgical Societies grades, and neuroimaging results. MRIs were categorized by CI pattern as single cortical (SC), single deep (SD), multiple cortical (MC), multiple deep (MD), and multiple cortical and deep (MCD).
  
  
  
  Among 123 (30.8 %) SAH patients who underwent MRIs during their hospitalization, 64 (52 %) demonstrated acute CI. The mean time from hospital admission to MRI was 5.7 days (range 0-29 days). Among the 64 patients with MRI infarcts, MRI CI pattern was as follows: MC in 20 (31 %), MCD in 18 (28 %), SC in 16 (25 %), SD in 3 (5 %), MD in 2 (3 %), and 5 (8 %) did not have images available for review. Most infarcts detected on MRI (39/64 or 61 %) were not visible on CT.
  
  
  
  The use of MRI increases the detection of CI in SAH. Unlike CT studies, MRI-detected CI in SAH tends to involve multiple vascular territories. Studies that rely on CT may underestimate the burden of CI after SAH.
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, 757 Westwood Blvd Room 6236, Los Angeles, CA, 90095, USA. georgiakorbakis@gmail.com.
authors.forename: Georgia
authors.initials: G
authors.lastname: Korbakis
authors.affiliation: Department of Neurology, Northwestern University Feinberg School of Medicine, 303 E Chicago Ave, Chicago, IL, 60611, US.
authors.forename: Shyam
authors.initials: S
authors.lastname: Prabhakaran
authors.affiliation: Section of Neurocritical Care, Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street #1121, Chicago, IL, 60612, US.
authors.forename: Sayona
authors.initials: S
authors.lastname: John
authors.affiliation: Section of Neurocritical Care, Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street #1121, Chicago, IL, 60612, US.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Garg
authors.affiliation: Section of Cerebrovascular Disease, Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street #1121, Chicago, IL, 60612, US.
authors.forename: James J
authors.initials: JJ
authors.lastname: Conners
authors.affiliation: Section of Neurocritical Care, Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street #1121, Chicago, IL, 60612, US.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Bleck
authors.affiliation: Section of Cerebrovascular Disease, Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street #1121, Chicago, IL, 60612, US.
authors.forename: Vivien H
authors.initials: VH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000145:classification* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Cerebral angiography; Cerebral infarction; Delayed cerebral ischemia; MRI; Subarachnoid hemorrhage