Magnetic Resonance Imaging in Intracerebral Hemorrhage

Intracerebral hemorrhage (ICH) has been traditionally imaged with computerized tomography (CT), which allows an immediate distinction between ICH and ischemia as the mechanism of an acute stroke. In recent years, the refining of several techniques of magnetic resonance (MR) imaging has allowed a more precise characterization of the anatomy of ICH, its associated events (such as surrounding edema), and its time-course. The latter has been facilitated by an understanding of the various biochemical changes that take place in and around the hematoma, and which correlate with the temporal course of the evolution of the ICH. In addition, the measurement of the susceptibility effect by MR imaging has permitted the identification of small asymptomatic microhemorrhages, which are potentially important predictors of ICH recurrence, as well as risk factors for ICH due to anticoagulant and thrombolytic treatment.