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Perihematomal edema in primary intracerebral hemorrhage is plasma derived

Ken S Butcher1, Tracey Baird, Lachlan MacGregor

  • 1Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia. Kenneth.butcher@mh.org.au

Stroke
|June 5, 2004
PubMed
Abstract

Insights

Acute intracerebral hemorrhage (ICH) causes perihematomal edema. Increased water diffusion in this area predicts edema volume, suggesting a plasma origin, while acute oligemia is not linked to ischemia or edema.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Mechanisms of injury around intracerebral hemorrhage (ICH) remain unclear.
  • Edema and blood flow changes post-ICH require further investigation.

Purpose of the Study:

  • To investigate perihematomal edema and blood flow dynamics in primary ICH.
  • To elucidate the relationship between edema, blood flow, and hematoma volume using MRI.

Main Methods:

  • Prospective study of 21 ICH patients using perfusion-weighted MRI (PWI) and diffusion-weighted MRI.
  • Coregistration of MRI and CT images to differentiate changes outside the hematoma.
  • Measurement of edema volumes and apparent diffusion coefficient (ADC) values in perihematomal regions.

Main Results:

  • Perihematomal oligemia (reduced blood flow) correlated with hematoma volume but not edema.
  • Increased ADC values in perihematomal regions were observed in all patients.
  • Higher perihematomal ADC values predicted edema volume, confirmed by multivariate analysis.

Conclusions:

  • Acute perihematomal oligemia occurs in ICH but is not associated with ischemia or edema.
  • Elevated water diffusion rates in the perihematomal region independently predict edema volume.
  • Findings suggest perihematomal edema in ICH is likely plasma-derived.

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