Intracranial hemorrhage MRI

Intracranial hemorrhage Microchapters
Patient Information
Overview
Classification Subdural hematoma Epidural hematoma Subarachnoid hemorrhage Intraventricular hemorrhage Intraparenchymal hemorrhage
Causes
Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

MRI

Subarachnoid Hemorrhage

• Fluid-attenuated inversion recovery (FLAIR) is the most sensitive MRI pulse sequence for the detection of SAH. SAH appears as high-intensity signal in normally low signal CSF spaces.
• 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.
• MR angiography may be useful in the evaluation of aneurysms and other vascular lesions that cause SAH.

Subdural Hemorrhage

• MRI is more sensitive than CT scanning in the detection of subdural hematomas because the multiplanar and superior tissue differentiation of MRI makes detection easier.

• The shape of the subdural hematoma on axial images is the same crescent-shaped pattern seen on CT scan images.

• The signal depends on the age of the hemorrhage and follows the signal pattern of intraparenchymal hematomas in acute and subacute cases.
• Chronic subdural hematomas, which appear as isoattenuation relative to CSF on CT scans, often demonstrate increased signal intensity on T1-weighted images because of the presence of free methemoglobin, though the intensity decreases over time.