Subacute Late Intracerebral Hemorrhage - Case 2

A 32 year-old woman presented with the abrupt onset of a severe headache associated with a mild left hemiplegia.

Note the Bright Signal on T1                                                      Note the Bright Signal on T2

Subacute Late Intracerebral Hemorrhage: (Left) T1-weighted axial MRI; (Right) T2-weighted axial MRI. Note on the T1-weighted MRI, there is an area of hyperintense signal in the right posterior frontal lobe. The same area is also hyperintense on the T2-weighted MRI.

This is the characteristic picture of subacute late hemorrhage (7-14 days old) on MRI. The hyperintense signal seen on both T1- and T2-weighted MRI is characteristic of extracellular methemoglobin. In this case, the hemorrhage was due to a deep arteriovenous malformation that bled.

The characteristic findings of blood on MRI at different stages of timing are complex. To learn more, review the powerpoint slide show, Blood on MRI: Time-dependent Changes.

Revised 11/11/06.
Copyrighted 2006. David C Preston.