Remote diffusion-weighted imaging lesions in spontaneous intracerebral hemorrhage: research progress and new...

Spontaneous or primary intracerebral hemorrhage (ICH) is considered the most severe form of stroke. Previous studies have focused mostly on local and perilesional changes in hematomas while paying less attention to damage in distant neural tissue. With the widespread use of magnetic resonance imaging (MRI) technology, an increasing number of studies have revealed that diffusion-weighted imaging (DWI) hyperintense lesions with low apparent diffusion coefficient (ADC) hypointensity can appear in remote areas away from the hematoma after ICH, indicating the presence of ischemic injury. However, the mechanism underlying their development remains unclear, and there is currently a lack of systematic reviews on the factors influencing remote DWI (R-DWI) lesions and their relationship with ICH prognosis. Additionally, some research findings are contradictory. Therefore, this review aims to systematically summarize the factors influencing R-DWI lesions after ICH and explore their predictive indicators, prognostic associations, and potential mechanisms.