Magnetic Resonance Imaging Characteristics of Hyperacute Intracerebral Hemorrhage.
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.


CONCLUSIONS
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.
Department of Neurology, University of Tennessee Health Sciences Center, Memphis, TN, USA.
Sulaiman
S
Iftikhar
Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, TN, USA.
Nicholas
N
Rossi
Department of Neurology, University of Tennessee Health Sciences Center, Memphis, TN, USA.
Nitin
N
Goyal
Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, TN, USA.
Nickalus
N
Khan
Department of Neurosurgery, University of Tennessee Health Sciences Center, Memphis, TN, USA; Semmes-Murphey Clinic, Memphis, TN, USA.
Adam
A
Arthur
Department of Neurology, University of Tennessee Health Sciences Center, Memphis, TN, USA.
Ramin
R
Zand
Intracerebral hemorrhage; fluid attenuated inversion recovery; hematoma; magnetic resonance imaging