Subarachnoid hemorrhage MRI

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AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Ahsan Hussain, M.D.[2] Cafer Zorkun, M.D., Ph.D. [3]; Sara Mehrsefat, M.D. [4]

Overview

MRI may indicated in all patients with subarachnoid hemorrhage if no lesion were found on prior angiography. MRI may be helpful in diagnosis of occult vascular lesions that can cause subarachnoid hemorrhage and may include brain and spinal cord vascular malformations, tumors, and arterial dissection.

MRI

  • The findings and indications of sub-arachnoid hemorrhage on MRI are given below:[1][2][3][2][4]

MRI may indicated in all patients with subarachnoid hemorrhage if no lesion were found on prior angiography.

Disadvantage of performing MRI in patients with subarachnoid hemorrhage may include:

  • Higher cost
  • Lower availability
  • Longer study time make it less optimal for detecting SAH. In addition
  • Not being sensitive for detection of subarachnoid hemorrhage within the first 48 hours

T2- and T2*-weighted images can potentially demonstrate SAH as low signal intensity in normally high-signal subarachnoid spaces. On T1-weighted images, acute SAH may appear as intermediate- or high-intensity signal in the subarachnoid space

References

  1. Wijdicks EF, Schievink WI, Miller GM (1998). "MR imaging in pretruncal nonaneurysmal subarachnoid hemorrhage: is it worthwhile?". Stroke. 29 (12): 2514–6. PMID 9836761.
  2. 2.0 2.1 Tatter SB, Crowell RM, Ogilvy CS (1995). "Aneurysmal and microaneurysmal "angiogram-negative" subarachnoid hemorrhage". Neurosurgery. 37 (1): 48–55. PMID 8587690.
  3. Rogg JM, Smeaton S, Doberstein C, Goldstein JH, Tung GA, Haas RA (1999). "Assessment of the value of MR imaging for examining patients with angiographically negative subarachnoid hemorrhage". AJR Am J Roentgenol. 172 (1): 201–6. doi:10.2214/ajr.172.1.9888768. PMID 9888768.
  4. Koch C (2006). "Spinal dural arteriovenous fistula". Curr Opin Neurol. 19 (1): 69–75. PMID 16415680.

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