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Evolution of Intracranial Hemorrhage
Karen L. Salzman, MD; Ulrich Rassner, MD
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KEY FACTS

  • Imaging

    • Pathology

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Intracerebral hematoma (ICH)
          • Synonyms

            • Intraparenchymal hemorrhage
          • Definitions

            • Parenchymal blood collection

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Ho CW et al: Ischemic stroke and intracranial hemorrhage with aspirin, dabigatran, and warfarin: impact of quality of anticoagulation control. Stroke. 46(1):23-30, 2015
                                      2. Sampath Kumar NS et al: Multiple spontaneous hypertensive intracerebral hemorrhages. J Stroke Cerebrovasc Dis. 24(1):e25-7, 2015
                                      3. Schelhorn J et al: Intracranial hemorrhage detection over time using susceptibility-weighted magnetic resonance imaging. Acta Radiol. ePub, 2014
                                      4. Taylor B et al: Underlying effect of age on outcome differences in arteriovenous malformation-associated intracerebral hemorrhage. J Clin Neurosci. ePub, 2014
                                      5. Toyoda K et al: Seeking best medical treatment for hyperacute intracerebral hemorrhage. Neurology. ePub, 2014
                                      6. van Etten ES et al: Incidence of symptomatic hemorrhage in patients with lobar microbleeds. Stroke. 45(8):2280-5, 2014
                                      7. Wang X et al: Clinical Prediction Algorithm (BRAIN) to Determine Risk of Hematoma Growth in Acute Intracerebral Hemorrhage. Stroke. ePub, 2014
                                      8. Cheng AL et al: Susceptibility-weighted imaging is more reliable than T2*-weighted gradient-recalled echo MRI for detecting microbleeds. Stroke. 44(10):2782-6, 2013
                                      9. Barras CD et al: Density and shape as CT predictors of intracerebral hemorrhage growth. Stroke. 40(4):1325-31, 2009
                                      10. Ederies A et al: Postcontrast CT extravasation is associated with hematoma expansion in CTA spot negative patients. Stroke. 40(5):1672-6, 2009
                                      11. Sacco S et al: Incidence and 10-year survival of intracerebral hemorrhage in a population-based registry. Stroke. 40(2):394-9, 2009
                                      12. Rost NS et al: The genetic architecture of intracerebral hemorrhage. Stroke. 39(7):2166-73, 2008
                                      13. Flaherty ML et al: The increasing incidence of anticoagulant-associated intracerebral hemorrhage. Neurology. 68(2):116-21, 2007
                                      14. Flaherty ML et al: Long-term mortality after intracerebral hemorrhage. Neurology. 66(8):1182-6, 2006
                                      15. Silvera S et al: Spontaneous intracerebral hematoma on diffusion-weighted images: influence of T2-shine-through and T2-blackout effects. AJNR Am J Neuroradiol. 26(2):236-41, 2005
                                      16. Woo D et al: Genetic and environmental risk factors for intracerebral hemorrhage: preliminary results of a population-based study. Stroke. 33(5):1190-5, 2002
                                      17. Parizel PM et al: Intracranial hemorrhage: principles of CT and MRI interpretation. Eur Radiol. 11(9):1770-83, 2001
                                      18. Liang L et al: Detection of intracranial hemorrhage with susceptibility-weighted MR sequences. AJNR Am J Neuroradiol. 20(8):1527-34, 1999
                                      19. Lampl Y et al: Neurological and functional outcome in patients with supratentorial hemorrhages. A prospective study. Stroke. 26(12):2249-53, 1995
                                      20. Pfleger MJ et al: Sensitivity and specificity of fluid-blood levels for coagulopathy in acute intracerebral hematomas. AJNR Am J Neuroradiol. 15(2):217-23, 1994
                                      21. Bradley WG Jr: MR appearance of hemorrhage in the brain. Radiology. 189(1):15-26, 1993
                                      22. Atlas SW et al: Intracranial hemorrhage: gradient-echo MR imaging at 1.5 T. Comparison with spin-echo imaging and clinical applications. Radiology. 168(3):803-7, 1988
                                      23. Gomori JM et al: Mechanisms responsible for the MR appearance and evolution of intracranial hemorrhage. Radiographics. 8(3):427-40, 1988
                                      24. Gomori JM et al: NMR relaxation times of blood: dependence on field strength, oxidation state, and cell integrity. J Comput Assist Tomogr. 11(4):684-90, 1987
                                      25. Gomori JM et al: Intracranial hematomas: imaging by high-field MR. Radiology. 157(1):87-93, 1985
                                      26. Laster DW et al: Resolving intracerebral hematoma: alteration of the "ring sign" with steroids. AJR Am J Roentgenol. 130(5):935-9, 1978
                                      27. Dolinskas CA et al: Computed tomography of intracerebral hematomas. I. Transmission CT observations on hematoma resolution. AJR Am J Roentgenol. 129(4):681-8, 1977
                                      28. New PF et al: Attenuation measurements of whole blood and blood fractions in computed tomography. Radiology. 121(3 Pt, 1976
                                      29. Eissner G et al: [Antibody levels in young cattle of varying races after a first anti-foot-and-mouth disease vaccination with vaccines prepared by different methods.] Bull Off Int Epizoot. 77(5):995-1003, 1972
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Imaging

                                        • Pathology

                                          • Clinical Issues

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Intracerebral hematoma (ICH)
                                              • Synonyms

                                                • Intraparenchymal hemorrhage
                                              • Definitions

                                                • Parenchymal blood collection

                                              IMAGING

                                              • General Features

                                                • CT Findings

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Staging, Grading, & Classification

                                                            • Gross Pathologic & Surgical Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Ho CW et al: Ischemic stroke and intracranial hemorrhage with aspirin, dabigatran, and warfarin: impact of quality of anticoagulation control. Stroke. 46(1):23-30, 2015
                                                                          2. Sampath Kumar NS et al: Multiple spontaneous hypertensive intracerebral hemorrhages. J Stroke Cerebrovasc Dis. 24(1):e25-7, 2015
                                                                          3. Schelhorn J et al: Intracranial hemorrhage detection over time using susceptibility-weighted magnetic resonance imaging. Acta Radiol. ePub, 2014
                                                                          4. Taylor B et al: Underlying effect of age on outcome differences in arteriovenous malformation-associated intracerebral hemorrhage. J Clin Neurosci. ePub, 2014
                                                                          5. Toyoda K et al: Seeking best medical treatment for hyperacute intracerebral hemorrhage. Neurology. ePub, 2014
                                                                          6. van Etten ES et al: Incidence of symptomatic hemorrhage in patients with lobar microbleeds. Stroke. 45(8):2280-5, 2014
                                                                          7. Wang X et al: Clinical Prediction Algorithm (BRAIN) to Determine Risk of Hematoma Growth in Acute Intracerebral Hemorrhage. Stroke. ePub, 2014
                                                                          8. Cheng AL et al: Susceptibility-weighted imaging is more reliable than T2*-weighted gradient-recalled echo MRI for detecting microbleeds. Stroke. 44(10):2782-6, 2013
                                                                          9. Barras CD et al: Density and shape as CT predictors of intracerebral hemorrhage growth. Stroke. 40(4):1325-31, 2009
                                                                          10. Ederies A et al: Postcontrast CT extravasation is associated with hematoma expansion in CTA spot negative patients. Stroke. 40(5):1672-6, 2009
                                                                          11. Sacco S et al: Incidence and 10-year survival of intracerebral hemorrhage in a population-based registry. Stroke. 40(2):394-9, 2009
                                                                          12. Rost NS et al: The genetic architecture of intracerebral hemorrhage. Stroke. 39(7):2166-73, 2008
                                                                          13. Flaherty ML et al: The increasing incidence of anticoagulant-associated intracerebral hemorrhage. Neurology. 68(2):116-21, 2007
                                                                          14. Flaherty ML et al: Long-term mortality after intracerebral hemorrhage. Neurology. 66(8):1182-6, 2006
                                                                          15. Silvera S et al: Spontaneous intracerebral hematoma on diffusion-weighted images: influence of T2-shine-through and T2-blackout effects. AJNR Am J Neuroradiol. 26(2):236-41, 2005
                                                                          16. Woo D et al: Genetic and environmental risk factors for intracerebral hemorrhage: preliminary results of a population-based study. Stroke. 33(5):1190-5, 2002
                                                                          17. Parizel PM et al: Intracranial hemorrhage: principles of CT and MRI interpretation. Eur Radiol. 11(9):1770-83, 2001
                                                                          18. Liang L et al: Detection of intracranial hemorrhage with susceptibility-weighted MR sequences. AJNR Am J Neuroradiol. 20(8):1527-34, 1999
                                                                          19. Lampl Y et al: Neurological and functional outcome in patients with supratentorial hemorrhages. A prospective study. Stroke. 26(12):2249-53, 1995
                                                                          20. Pfleger MJ et al: Sensitivity and specificity of fluid-blood levels for coagulopathy in acute intracerebral hematomas. AJNR Am J Neuroradiol. 15(2):217-23, 1994
                                                                          21. Bradley WG Jr: MR appearance of hemorrhage in the brain. Radiology. 189(1):15-26, 1993
                                                                          22. Atlas SW et al: Intracranial hemorrhage: gradient-echo MR imaging at 1.5 T. Comparison with spin-echo imaging and clinical applications. Radiology. 168(3):803-7, 1988
                                                                          23. Gomori JM et al: Mechanisms responsible for the MR appearance and evolution of intracranial hemorrhage. Radiographics. 8(3):427-40, 1988
                                                                          24. Gomori JM et al: NMR relaxation times of blood: dependence on field strength, oxidation state, and cell integrity. J Comput Assist Tomogr. 11(4):684-90, 1987
                                                                          25. Gomori JM et al: Intracranial hematomas: imaging by high-field MR. Radiology. 157(1):87-93, 1985
                                                                          26. Laster DW et al: Resolving intracerebral hematoma: alteration of the "ring sign" with steroids. AJR Am J Roentgenol. 130(5):935-9, 1978
                                                                          27. Dolinskas CA et al: Computed tomography of intracerebral hematomas. I. Transmission CT observations on hematoma resolution. AJR Am J Roentgenol. 129(4):681-8, 1977
                                                                          28. New PF et al: Attenuation measurements of whole blood and blood fractions in computed tomography. Radiology. 121(3 Pt, 1976
                                                                          29. Eissner G et al: [Antibody levels in young cattle of varying races after a first anti-foot-and-mouth disease vaccination with vaccines prepared by different methods.] Bull Off Int Epizoot. 77(5):995-1003, 1972