Acute Intracerebral Hemorrhage - Case 6

A 60 year old man developed headache followed by an aphasia and right sided weakness.

Outline the Blood on CT   Note the Hypo-intense Signal on T1   Note the Hypo-intense Signal on T2   Show the Surrounding Vasogenic Edema

(Left) Axial CT scan' (Middle) T1-weighted; (Right) T2-weighted. Note on the CT that the intracerebral hemorrhage in the left frontal lobe is quite obvious. On the MRI scans, note the patternon T1 and T2 of an acute bleed. On T1, the lesion is slightly hypointense The same area on T2 is hypointense with a surrounding bright signal. This is the characteristic picture of  an acute (approximately 3 day old) hemorrhage on MRI. In the acute stage, intracellular deoxyhemoglobin is isointense / hypointense on T1 and hypointense on T2. The surrounding edema on T2 is hyperintense. The findings of blood on MRI are complex and depend on timing. To learn more, review the powerpoint slide show, Blood on MRI: Time-dependent Changes. In this case, the hemorrhage was due to hypertension. 

Revised 05/02/06.
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