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Mottled MR appearance of a hyperacute intracerebral hemorrhage at 0.5 T
1Department of Clinical Pathophysiology, University of Florence, Italy.
Abstract:
A hypertensive patient was examined by CT and magnetic resonance (0.5 T) within 3 h from stroke onset. Computed tomography revealed a thalamocapsular hemorrhage. Hematoma was isointense to the white matter on T1-weighted and hyperintense on T2-weighted spin echo images. The T2-weighted gradient echo images showed a mixture of hypointense and hyperintense signal. This latter aspect has not previously been reported and is probably related to abundant intracellular deoxyhemoglobin in clotted areas rich in red blood cells.
Insights
This study examines thalamocapsular hemorrhage using CT and MRI. New T2-weighted gradient echo findings suggest intracellular deoxyhemoglobin in red blood cells contributes to imaging signals in stroke patients.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Hypertension is a major risk factor for stroke.
- Thalamocapsular hemorrhage is a specific type of intracerebral hemorrhage.
- Early diagnosis of hemorrhagic stroke is crucial for patient management.
Observation:
- A patient with hypertension and stroke underwent Computed Tomography (CT) and 0.5 Tesla Magnetic Resonance (MR) imaging within 3 hours of symptom onset.
- CT identified a thalamocapsular hemorrhage.
- MR imaging revealed specific signal characteristics on different sequences.
Findings:
- The hematoma was isointense to white matter on T1-weighted images and hyperintense on T2-weighted spin echo images.
- Uniquely, T2-weighted gradient echo images displayed a mixed hypointense and hyperintense signal.
- This novel observation is attributed to intracellular deoxyhemoglobin within red blood cells in clotted areas.
Implications:
- These findings enhance the understanding of MR signal alterations in acute hemorrhagic stroke.
- Gradient echo sequences may offer additional diagnostic information in thalamocapsular hemorrhages.
- Further research could refine MR imaging protocols for early stroke detection and characterization.