Brain edema after human cerebral hemorrhage: a magnetic resonance imaging volumetric analysis

Although perihematoma brain edema can significantly modify neurologic outcome after intracerebral hemorrhage (ICH), our knowledge of its natural history is incomplete. We report on the correlation between hematoma (HV) and edema volumes (EV) in 14 patients with ICH during the first week after the ictus using MRI volumetric analysis. We conducted a retrospective MRI volumetric analysis of intraparenchymal hematomas and surrounding perihematoma brain edema in 14 patients with ICH. The mean age was 54.4 years (range 32-71 years). The time from symptom onset to MRI was 3.5 days (range 1-6) days, and the etiology of ICH was as follows: hypertension (70%), arteriovenous malformation rupture (19%), and postpallidotomy (11%). The mean HV was 15 mL (range 0.9-67.4 mL), and the mean EV was 17.3 mL (range 2.8-50.6 mL). Using linear regression analysis, we demonstrated EV to be significantly and directly related to HV: (EV) = 7.68 + 0.64(HV); r = 0.8; P = 0.001. In conclusion, we report significant and direct correlation between the HV and EV within the first week after ICH. The clinical implications of this observation, if confirmed, will help to better design clinical trials in ICH research as well as to better allocate adequate clinical resources in high-risk subgroups of patients with ICH.