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Changes in Cerebral Blood Flow and Diffusion-Weighted Imaging Lesions After Intracerebral Hemorrhage
Jingfei Yang1, Jie Jing1, Shiling Chen1
1Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, NO, China.
Insights
Intracerebral hemorrhage (ICH) can lead to secondary ischemic lesions on diffusion-weighted imaging (DWI), impacting patient outcomes. Understanding these DWI lesions is crucial for developing new treatments for ICH survivors.
Area of Science:
- Neurology
- Neuroimaging
- Stroke Medicine
Background:
- Intracerebral hemorrhage (ICH) is a severe stroke subtype with high mortality and disability.
- Cerebral ischemic lesions on diffusion-weighted imaging (DWI) are frequently observed in ICH patients.
- These DWI lesions are linked to poor prognosis, cognitive decline, and increased stroke recurrence.
Purpose of the Study:
- To review changes in cerebral blood flow (CBF) and DWI lesions post-ICH.
- To explore risk factors and mechanisms contributing to DWI lesion development.
- To highlight the importance of understanding DWI lesions for therapeutic development.
Main Methods:
- Review of existing imaging and pathological studies on ICH.
- Analysis of factors influencing cerebral blood flow and DWI lesion formation.
- Discussion of potential pathophysiological mechanisms.
Main Results:
- DWI lesions are common after ICH and associated with adverse outcomes.
- Factors like microangiopathy, atherosclerosis, aggressive blood pressure lowering, hyperglycemia, and inflammation contribute to DWI lesions.
- Changes in CBF are observed in relation to ICH and DWI lesions.
Conclusions:
- Secondary DWI lesions are a significant complication of ICH.
- Identifying risk factors and mechanisms is essential for managing DWI lesions.
- Further understanding of DWI lesions is key to improving long-term recovery in ICH patients.
Abstract:
Intracerebral hemorrhage (ICH) is a common subtype of stroke and places a great burden on the family and society with a high mortality and disability rate and a poor prognosis. Many findings from imaging and pathologic studies have suggested that cerebral ischemic lesions visualized on diffusion-weighted imaging (DWI) in patients with ICH are not rare and are generally considered to be associated with poor outcome, increased risk of recurrent (ischemic and hemorrhagic) stroke, cognitive impairment, and death. In this review, we describe the changes in cerebral blood flow (CBF) and DWI lesions after ICH and discuss the risk factors and possible mechanisms related to the occurrence of DWI lesions, such as cerebral microangiopathy, cerebral atherosclerosis, aggressive early blood pressure lowering, hyperglycemia, and inflammatory response. We also point out that a better understanding of cerebral DWI lesions will be a key step toward potential therapeutic interventions to improve long-term recovery for patients with ICH.
