Subacute Early Intracerebral Hemorrhage - Case 3

A 53 year-old man presented with a headache and progressive numbness affecting the right arm with loss of vision on the right side which slowly progressed over several hours.


Note the Bright Signal on T1        Note the Dark Signal on T2        Show the Surrounding Vasogenic Edema

Subacute Early Intracerebral Hemorrhage: (Left) T1-weighted axial MRI; (Right) T2-weighted axial MRI. Note on the T1-weighted image, there is an area of hyperintense signal in the left parietal/occipital lobe. The same area on the T2-weighted image is hypointense with a surrounding bright signal.

This is the characteristic picture of a subacute early (3-7 days) hemorrhage on MRI. The hyperintense signal on the T1-weighted image with the hypointense (dark) signal on the T2-weighted image is the pattern seen with intracellular methemoglobin. The bright surrounding signal on the T2-weighted image is vasogenic edema. In this case, the hemorrhage was due to hypertension.

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 11/23/06.
Copyrighted 2006. David C Preston.