Chronic Intracerebral Hemorrhage

Chronic Intracerebral Hemorrhage

Ashley Davidoff MD

The Common Vein Copyright 2010


Aging the Hemorrhage on MRI

Hyperacute – minutes to hours

T1 – hematoma  (deoxyHb) dark => isointense

T2 – hematoma (deoxyHb) dark=> isointense

Acute – 0-2 days

deoxyhemoglobin is in intact RBCs with surrounding edema

T1- hematoma isointense, edema dark

T2 – hematoma  dark, edema bright

Subacute – 2-14 days

deoxyhemoglobin changes to methemoglobin from outer to inner

T1 – outer core bright

T2 – outer core bright due to shortened T1, longer T2

Chronic – 14 days

hemosiderin laden macrophages at periphery

T1 – inner core bright, rim dark

T2 – inner core bright, rim has low dark

Chronic – months later

hemosiderin laden macrophages at periphery

T1- mostly iso-/dark, rim is dark

T2- markedly dark rim – “blooms” with greater T2-weighting

Control Center