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Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
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A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...

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Area of Science:

  • Neurology
  • Neurosurgery
  • Medical Imaging

Background:

  • Magnetic resonance-guided focused ultrasound (MRgFUS) is an emerging therapy for movement disorders.
  • Severe complications are rare, but technical issues like cavitation can occur.
  • Intracranial bleeding associated with MRgFUS has not been previously reported.

Purpose of the Study:

  • To report two cases of symptomatic brain hemorrhage during MRgFUS ablation.
  • To highlight the potential association between cavitation and intracranial bleeding.
  • To inform clinical practice regarding rare but serious MRgFUS complications.

Main Methods:

  • Two patients with essential tremor and Parkinson disease underwent MRgFUS ablation.
  • Cavitation occurred during treatment despite power reduction attempts.
  • Post-treatment imaging revealed intracranial hematomas in both patients.

Main Results:

  • Both patients experienced motor weakness post-procedure.
  • Brain CT scans confirmed hemorrhage in the targeted areas.
  • One patient recovered, while the other experienced persistent disability.

Conclusions:

  • Brain bleeding is a rare complication of MRgFUS ablation, occurring in 0.4% of cases in this series.
  • Uncontrollable cavitation may increase the risk of intracranial hemorrhage.
  • A conservative treatment strategy is advised to mitigate this risk.