Spin-echo MRI of chronic intracerebral haematomas

Our purpose was to characterise the MRI appearances of clinically non-neoplastic chronic intracerebral haematomas (ICH). We examined 25 patients with a history of clinically non-neoplastic 0.5-to 1.5-year-old ICH who underwent prospective follow-up 1.0-T spin-echo MRI of the brain. On T1-weighted images most lesions gave lower signal than white matter and were isointense with cerebrospinal fluid (CSF). On T2-weighted images most were either totally low-signal and slit-like, or had a high-signal centre and a low-signal margin. The low-signal (haemosiderin) rim showed areas of discontinuity in 7 cases. Of 24 lesions, 4 showed small enhancing areas on contrast-enhanced images. In 10 cases the brain parenchyma surrounding the lesion showed high-signal on T2- and low signal on T1-weighted images, probably representing encephalomalacia. In 20 cases enlargement of a nearby CSF space was observed, and 14 cases showed atrophy of the brain stem ipsilateral to the lesion. We thus found more variation on MRI of clinically non-neoplastic chronic ICH than previously described.