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Diffusion abnormality of deep gray matter in external capsular hemorrhage
Won-Jin Moon1, Dong Gyu Na, Sam Soo Kim
1Department of Radiology, Kangbuk Samsung Hospital, Seoul, Korea.
AJNR. American Journal of Neuroradiology
|February 15, 2005
Summary
External capsular hemorrhage can cause diffusion abnormalities in deep gray matter, distinct from the initial bleed. This finding, potentially due to secondary neuronal degeneration, should not be mistaken for new infarction.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Diffusion abnormality in unaffected deep gray matter following striatocapsular hemorrhage is not well-documented.
- External capsular (lateral striatocapsular) hemorrhage is a specific type of intracerebral hemorrhage.
Purpose of the Study:
- To describe diffusion abnormalities in deep gray matter remote from the hematoma in patients with external capsular hemorrhage.
- To suggest potential mechanisms for these diffusion signal intensity changes.
Main Methods:
- Retrospective review of MR images from 28 patients with spontaneous striatocapsular hemorrhage.
- Evaluation of signal intensity changes on diffusion-weighted (DW) images in areas separate from the hemorrhage.
- Measurement of apparent diffusion coefficients (ADCs) and assessment of deep gray matter volume changes.
Main Results:
- Nine patients (25%) showed deep gray matter hyperintensity on DW images, all with external capsule hemorrhages.
- Abnormalities were observed in the caudate, putamen, thalamus, and substantia nigra.
- Mean relative ADC ratios indicated restricted diffusion, which resolved with mild atrophy in follow-up imaging.
Conclusions:
- External capsular hemorrhage can be associated with delayed diffusion abnormalities in the striatum or thalamus.
- These findings may represent secondary neuronal degeneration and should be differentiated from acute infarction.
- Diffusion abnormalities are a potential imaging finding in the follow-up of external capsular hemorrhage.