Tissue damage at computed tomography following resolution of intracerebral hematomas

Tissue damage as sequelae after spontaneous intracerebral hemorrhage in eight consecutive patients was investigated with computed tomography performed 3 days, 2 weeks and 6 months after the stroke. The presence of contrast enhancement after 2 weeks, hypodense areas after 6 months, and atrophy of adjacent structures were considered to be markers of irreversible tissue damage. Except for a narrow zone in the periphery of the hematoma (ring blush) contrast enhancement was not observed, neither in the hematoma nor in areas where resolution had taken place. After 6 months the site of the hematomas was not identifiable in 3 patients, and 4 patients had small 'lacunar' hypodense lesions. Only one patient had a more extensive hypodense area 6 months after the hemorrhage. The most prominent sequelae after intracerebral hematoma were atrophy of adjacent structures (i.e. atrophy of basal ganglia, thalamus and ventricular enlargement) which were seen in all patients even though irreversible de loco damage in the hematoma area was sparse or absent.