A 63 year old man was in an automobile accident, and found to be in a coma at the scene. |
Hyperacute Intracerebral Hemorrhage: (Left) Axial CT scan; (Middle) T1-weighted
axial MRI; (Right) T2-weighted axial MRI. Note that on the
CT scan the intracerebral hemorrhage in the frontal lobes is quite obvious.
However, on the MRI scans, hyperacute blood is much more difficult to recognize.
On the T1-weighted scan, note that there
are several areas of abnormality that are relatively isointense to slightly hypointense. The same
area on the T2-weighted scan is isointense to hyperintense, with a
surrounding bright signal. This is the characteristic picture of a
hyperacute (approximately 1 day old) hemorrhage on MRI. In the
hyperacute stage, intracellular oxyhemoglobin is isointense /
hypointense on T1-weighted and isointense / hyperintense on
T2-weighted scans. In this case, the hemorrhage was due to
trauma. The findings of blood on MRI are complex and depend on timing. To learn more, review the powerpoint slide show, Blood on MRI: Time-dependent Changes. |
Revised
11/30/06.
Copyrighted 2006. David C Preston.