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Updated: Apr 14, 2026
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Diagnostic evaluation for nontraumatic intracerebral hemorrhage
Renan Domingues1, Costanza Rossi2, Charlotte Cordonnier2
1Department of Neurology, University of Lille, UDSL, CHU Lille, Inserm U 1171, Lille 59000, France; CAPES Foundation, Ministry of Education, Quadra 2, Bloco L, Lote 06, Edifício Capes - CEP: 70.040-020 - Brasilia-DF, Brazil.
Insights
Intracerebral hemorrhage (ICH) requires prompt diagnosis, with advanced imaging like MRI crucial for identifying causes. Conventional angiography is the gold standard for detecting vascular malformations in ICH patients.
Area of Science:
- Neurology
- Radiology
- Medical Diagnostics
Background:
- Intracerebral hemorrhage (ICH) is a severe neurological condition with diverse etiologies.
- Accurate and timely diagnosis of ICH is critical for effective patient management.
- Clinical symptoms alone are insufficient for reliable ICH diagnosis.
Purpose of the Study:
- To outline the diagnostic work-up for intracerebral hemorrhage.
- To emphasize the role of neuroimaging in ICH diagnosis and etiology determination.
- To highlight the importance of identifying underlying structural lesions.
Main Methods:
- Review of diagnostic imaging modalities for ICH.
- Discussion of the utility of noncontrast computed tomography (CT) and magnetic resonance imaging (MRI).
- Evaluation of vessel imaging techniques for detecting structural abnormalities.
Main Results:
- Noncontrast CT and MRI are highly sensitive for detecting ICH.
- MRI can reveal parenchymal biomarkers aiding in etiological diagnosis.
- Conventional angiography is the definitive method for diagnosing intracranial vascular malformations.
Conclusions:
- Neuroimaging is essential for ICH diagnosis and etiological work-up.
- MRI offers additional value by identifying biomarkers for cause determination.
- Vessel examination, particularly conventional angiography, is crucial when structural lesions are suspected.
Abstract:
Intracerebral hemorrhage (ICH) is a devastating condition with multiple possible underlying causes. Early diagnosis of ICH associated with a precise diagnostic work-up is mandatory. Clinical signs may give clues to diagnosis but are not reliable enough and imaging remains the cornerstone of management. Noncontrast computed tomography and magnetic resonance imaging (MRI) are highly sensitive for ICH identification. Additionally, MRI may disclose brain parenchymal biomarkers that can contribute to the etiologic diagnosis. Vessel examination should be carried out whenever there is a clinical suspicion of underlying structural lesions, such as vascular malformations or tumors. To date, conventional angiography remains the gold standard to detect intracranial vascular malformations in patients with ICH.
