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Updated: Mar 30, 2026
Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging MRI
Published on: December 16, 2021
MRI Detection of Cerebral Infarction in Subarachnoid Hemorrhage
Georgia Korbakis1, Shyam Prabhakaran2, Sayona John3
1Department of Neurosurgery, University of California Los Angeles, 757 Westwood Blvd Room 6236, Los Angeles, CA, 90095, USA. georgiakorbakis@gmail.com.
Objective:
To investigate magnetic resonance imaging (MRI) detection of cerebral infarction (CI) in patients presenting with subarachnoid hemorrhage (SAH).
Background:
CI is a well-known complication of SAH that is typically detected on computed tomography (CT). MRI has improved sensitivity for acute CI over CT, particularly with multiple, small, or asymptomatic lesions.
Methods:
With IRB approval, 400 consecutive SAH patients admitted to our institution from August 2006 to March 2011 were retrospectively reviewed. Traumatic SAH and secondary SAH were excluded. Data were collected on demographics, cause of SAH, Hunt Hess and World Federation of Neurosurgical Societies grades, and neuroimaging results. MRIs were categorized by CI pattern as single cortical (SC), single deep (SD), multiple cortical (MC), multiple deep (MD), and multiple cortical and deep (MCD).
Results:
Among 123 (30.8 %) SAH patients who underwent MRIs during their hospitalization, 64 (52 %) demonstrated acute CI. The mean time from hospital admission to MRI was 5.7 days (range 0-29 days). Among the 64 patients with MRI infarcts, MRI CI pattern was as follows: MC in 20 (31 %), MCD in 18 (28 %), SC in 16 (25 %), SD in 3 (5 %), MD in 2 (3 %), and 5 (8 %) did not have images available for review. Most infarcts detected on MRI (39/64 or 61 %) were not visible on CT.
Conclusions:
The use of MRI increases the detection of CI in SAH. Unlike CT studies, MRI-detected CI in SAH tends to involve multiple vascular territories. Studies that rely on CT may underestimate the burden of CI after SAH.
Insights
Magnetic resonance imaging (MRI) significantly enhances the detection of cerebral infarction (CI) in patients with subarachnoid hemorrhage (SAH). MRI reveals more CIs than computed tomography (CT), often affecting multiple brain areas.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Cerebral infarction (CI) is a known complication of subarachnoid hemorrhage (SAH).
- Computed tomography (CT) typically detects CI, but magnetic resonance imaging (MRI) offers superior sensitivity for acute, small, or asymptomatic lesions.
Purpose of the Study:
- To evaluate the effectiveness of MRI in detecting cerebral infarction (CI) in patients with subarachnoid hemorrhage (SAH).
Main Methods:
- Retrospective review of 400 SAH patients, excluding traumatic and secondary SAH.
- Analysis of neuroimaging results, specifically MRI, for acute CI detection and pattern classification.
- Comparison of MRI findings with CT scans for CI detection.
Main Results:
- Of 123 SAH patients who underwent MRI, 64 (52%) showed acute CI.
- MRI detected CIs not visible on CT in 61% of cases (39/64).
- Common MRI CI patterns included multiple cortical (MC) and multiple cortical and deep (MCD).
Conclusions:
- MRI significantly increases the detection rate of CI in SAH patients compared to CT.
- MRI-detected CIs in SAH frequently involve multiple vascular territories.
- CT imaging may underestimate the prevalence and extent of CI following SAH.
