Related Experiment Video
Updated: Mar 13, 2026
Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging MRI
Published on: December 16, 2021
Longitudinal profile of iron accumulation in good-grade subarachnoid hemorrhage
Christoph Scherfler1, Alois Josef Schiefecker2, Margarete Delazer2
1Department of Neurology Medical University of Innsbruck Innsbruck Austria; Neuroimaging Research Core Facility Medical University of Innsbruck Innsbruck Austria.
Objective:
MRI parameters of iron concentration (R2*, transverse relaxation rate), microstructural integrity (mean diffusivity and fractional anisotropy), as well as gray and white matter volumes were analyzed in patients with subarachnoid hemorrhage (SAH) and uncomplicated clinical course to detect the evolution of brain tissue changes 3 weeks and 12 months after ictus.
Methods:
MRI scans of 14 SAH patients (aneurysm of the anterior communicating artery, n = 5; no aneurysm n = 9) were compared with 14 age-matched healthy control subjects. Statistical parametric mapping (SPM) was applied to objectively identify focal changes of MRI parameters throughout the entire brain and to correlate image parameters with neuropsychological measures.
Results:
SPM localized significant bilateral increases in R2* signal within the white matter compartment of the temporal and parietal lobe and the cingulate gyrus (P < 0.001) which did not change significantly at 12 months. Significant gray matter volume reduction of the left insula and superior temporal gyrus (P < 0.001), as well as decreases in fractional anisotropy of the cingulate gyrus (P < 0.01) were also evident at 12 months. Significant correlations were found between fractional anisotropy signal alterations adjacent to the left middle and superior frontal gyrus and cognitive parameters of executive dysfunction (P < 0.001).
Interpretation:
The study indicates that iron is trapped predominantly throughout large portions of the white matter compartment in SAH patients at 12 months postbleeding. Increased disintegration of fiber tracts colocalizing with iron overload and correlating with lower executive function performance suggests that the white matter compartment is primarily susceptible toward long-term damage in patients with good clinical grade SAH.
Insights
Subarachnoid hemorrhage (SAH) patients show long-term white matter damage, including iron buildup and fiber tract disintegration, correlating with executive dysfunction. This highlights white matter susceptibility in SAH recovery.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Subarachnoid hemorrhage (SAH) can lead to long-term neurological deficits.
- Understanding the evolution of brain tissue changes post-SAH is crucial for patient recovery.
- Previous studies have focused on acute effects, with less known about chronic changes.
Purpose of the Study:
- To investigate the long-term evolution of brain tissue changes in subarachnoid hemorrhage (SAH) patients.
- To analyze MRI parameters including iron concentration, microstructural integrity, and gray/white matter volumes.
- To correlate imaging findings with neuropsychological measures in SAH patients with an uncomplicated clinical course.
Main Methods:
- 14 SAH patients and 14 age-matched healthy controls underwent MRI scans.
- Statistical Parametric Mapping (SPM) was used to identify focal changes in MRI parameters.
- MRI parameters analyzed included R2*, mean diffusivity, fractional anisotropy, and gray/white matter volumes at 3 weeks and 12 months post-ictus.
Main Results:
- Significant bilateral R2* increases (iron concentration) in white matter were observed, persisting at 12 months.
- Gray matter volume reduction in the left insula and superior temporal gyrus was noted at 12 months.
- Decreased fractional anisotropy in the cingulate gyrus and correlations between white matter integrity and executive dysfunction were found.
Conclusions:
- Iron accumulates in the white matter of SAH patients 12 months post-ictus.
- White matter damage, including fiber tract disintegration and iron overload, correlates with executive dysfunction.
- The white matter compartment appears primarily susceptible to long-term damage in good clinical grade SAH patients.
