Hemorrhagic stroke other imaging findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Other imaging findings in diagnosis of intracerebral hemorrhage may include gradient echo (GRE), CT angiography (CTA), CT venography (CTV), MR angiography (MRA), MR venography (MRV), and actheter angiogram.
Other imaging findings
Gradient echo (GRE)
- Gradient echo (GRE) is as sensitive as CT for detection of acute blood and are more sensitive for identification of prior hemorrhage.[1][2]
CTA/CTV
- CT angiography (CTA) may identify patients at high risk of intracerebral hemorrhage (ICH) expansion based upon the presence of contrast extravasation within the hematoma.[3][4]
- CTA/CTV are reasonably sensitive at identifying secondary causes of hemorrhage, including:[5]
- Arteriovenous malformations (AVM)
- Tumors
- Moyamoya
- Cerebral vein thrombosis
- A CT venogram should be performed if neuroimaging suggest [[cerebral vein thrombosis] (abnormal signal in the cerebral sinuses)
MRA/MRV
- MRA/ MRV are reasonably sensitive at identifying secondary causes of hemorrhage, including:[6]
- Arteriovenous malformations (AVM)
- Tumors
- Moyamoya
- Cerebral vein thrombosis
- An MR venogram should be performed if neuroimaging suggest [[cerebral vein thrombosis] (abnormal signal in the cerebral sinuses).
Catheter angiogram
A catheter angiogram may be considered if clinical suspicion is high or noninvasive studies are suggestive of an underlying lesion.[7]
Catheter angiography may indicated in following conditions:[8]
- Abnormal calcifications in patient with SAH or ICH
- Blood in atypical locations (SAH in patients with headache or nonhypertensive participants with basal ganglion hematoma)
- Young patients with no obvious cause for ICH
References
- ↑ Fiebach JB, Schellinger PD, Gass A, Kucinski T, Siebler M, Villringer A; et al. (2004). "Stroke magnetic resonance imaging is accurate in hyperacute intracerebral hemorrhage: a multicenter study on the validity of stroke imaging". Stroke. 35 (2): 502–6. doi:10.1161/01.STR.0000114203.75678.88. PMID 14739410.
- ↑ Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM; et al. (2007). "Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison". Lancet. 369 (9558): 293–8. doi:10.1016/S0140-6736(07)60151-2. PMC 1859855. PMID 17258669.
- ↑ Bartlett ST, Kuo PC, Johnson LB, Lim JW, Schweitzer EJ (1996). "Pancreas transplantation at the University of Maryland". Clin Transpl: 271–80. PMID 9286577.
- ↑ Becker KJ, Baxter AB, Bybee HM, Tirschwell DL, Abouelsaad T, Cohen WA (1999). "Extravasation of radiographic contrast is an independent predictor of death in primary intracerebral hemorrhage". Stroke. 30 (10): 2025–32. PMID 10512902.
- ↑ Mallampalli RK, Walter ME, Peterson MW, Hunninghake GW (1994). "Betamethasone activation of CTP:cholinephosphate cytidylyltransferase in vivo is lipid dependent". Am J Respir Cell Mol Biol. 10 (1): 48–57. doi:10.1165/ajrcmb.10.1.8292380. PMID 8292380.
- ↑ Yoon HK, Shin HJ, Lee M, Byun HS, Na DG, Han BK (2000). "MR angiography of moyamoya disease before and after encephaloduroarteriosynangiosis". AJR Am J Roentgenol. 174 (1): 195–200. doi:10.2214/ajr.174.1.1740195. PMID 10628478.
- ↑ Delgado Almandoz JE, Jagadeesan BD, Moran CJ, Cross DT 3rd, Zipfel GJ, Lee JM, Romero JM, Derdeyn CP. Independent validation of the secondary intracerebral hemorrhage score with catheter angiog- raphy and findings of emergent hematoma evacuation. Neurosurgery. 2012;70:131–140. doi: 10.1227/NEU.0b013e31822fbf43.
- ↑ Aguilar MI, Demaerschalk BM (2007). "Intracerebral hemorrhage". Semin Neurol. 27 (4): 376–84. doi:10.1055/s-2007-985338. PMID 17701875.