Imaging of Central Nervous System Hemorrhage

Area of Science:

• Neurology
• Radiology
• Neurosurgery

Background:

• Intraparenchymal hemorrhage constitutes 28% of the global stroke burden, with incidence rising with age.
• Hemorrhagic stroke accounts for 13% of all strokes in the United States.
• Autopsy studies reveal high rates of intraparenchymal hemorrhage and cerebral amyloid angiopathy in aging populations.

Purpose of the Study:

• To familiarize readers with nontraumatic central nervous system (CNS) hemorrhage types.
• To outline neuroimaging modalities for diagnosing and managing CNS hemorrhage.
• To briefly discuss nontraumatic spinal cord hemorrhage.

Main Methods:

• Head CT and brain MRI are essential for rapid identification of CNS hemorrhage.
• Etiologic assessment involves analyzing blood patterns, patient history, and physical examination.
• Subsequent diagnostic steps include tailored neuroimaging, laboratory, and ancillary tests.

Main Results:

• Nontraumatic CNS hemorrhage includes intraparenchymal, intraventricular, and subarachnoid hemorrhage.
• Neuroimaging patterns guide the diagnostic workup and treatment strategy.
• Treatment focuses on limiting hemorrhage expansion and preventing complications like edema and hydrocephalus.

Conclusions:

• Accurate diagnosis of CNS hemorrhage relies on prompt neuroimaging.
• Understanding hemorrhage patterns is key to determining the cause and guiding treatment.
• Effective management aims to reduce morbidity and mortality associated with CNS hemorrhage.