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Updated: Mar 21, 2026
Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging MRI
Published on: December 16, 2021
Multiple Episodes of Hemorrhage Identified in MRI of Chronic Subdural Hematomas
Dong-Ho Seo1, Kyeong-Seok Lee1, Jae-Joon Shim1
1Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Objective:
Septa within the hematoma cavity are common, especially in the mixed density chronic subdural hematomas (CSHs). Although CT remains the diagnosis of choice, MRI is superior to detect the membranes in CSHs. We could obtain MRIs in 64 patients with CSH. We examined the value of MRI to understand the history of CSH.
Methods:
We retrospectively examined the medical records and MRIs of 64 consecutive patients. MRI was selected to find any organic causes of neurologic symptoms. We classified the CSHs into septated or non-septated group, since classification of the septa was frequently obscure.
Results:
Septa were identified by MRI in 43 patients (67%). They were more common in the over 70-years-old group. Unknown causes were more common in the septated group, which implies they might suffer from multiple traumas. The signal intensity of the CSH was variable. The methods of treatment were different between two groups. Surgery was more common in the septated group (p=0.021). Surgery was performed in 57 patients (89%). Burr-hole drainage was successful in 55 patients, even in the septated group.
Conclusion:
Septa within the hematoma cavity may be related to the multiple episodes of head trauma. Repeated trauma may cause acute bleedings over the CSHs, which is one of the pathogenic mechanisms of hematoma enlargement. MRI could show the history of CSH.
Insights
Magnetic Resonance Imaging (MRI) effectively detects septa in chronic subdural hematomas (CSHs), suggesting a history of multiple head traumas. This imaging modality aids in understanding CSH progression and treatment strategies.
Area of Science:
- Neurosurgery
- Radiology
- Neurology
Background:
- Septa are common in chronic subdural hematomas (CSHs), particularly those with mixed density.
- Computed Tomography (CT) is standard for CSH diagnosis, but Magnetic Resonance Imaging (MRI) offers superior visualization of internal membranes.
Purpose of the Study:
- To evaluate the utility of MRI in identifying septa within CSH cavities.
- To correlate the presence of septa with patient history and treatment outcomes.
- To understand the role of MRI in elucidating the history of CSH.
Main Methods:
- Retrospective analysis of medical records and MRI scans from 64 consecutive CSH patients.
- Classification of CSHs into septated and non-septated groups based on MRI findings.
- Investigation of potential organic causes for neurological symptoms.
Main Results:
- MRI identified septa in 67% of CSH patients, with higher prevalence in individuals over 70.
- The septated group showed a higher incidence of unknown causes, suggesting potential multiple traumas.
- Surgical intervention was more frequent in the septated group (p=0.021), with successful outcomes via burr-hole drainage in most cases.
Conclusions:
- The presence of septa in CSH may indicate repeated head trauma, contributing to hematoma enlargement.
- MRI is a valuable tool for visualizing CSH septations and inferring the hematoma's history.
- Understanding septal presence influences treatment decisions and prognosis.
