Intracranial Hemorrhage on MRI

The table above shows how we stage (name) hematomas according to time. Important observation is that the very early (hyperacute) hematomas contain Oxyhemoglobin and are difficult to see (isodense to brain) on T1 sequences. Same with Deoxyhemoglobin. Then after about 3 days we start to see high signal of Methemoglobin on T1. That continues to be high on T1 even when Methemoglobin is released from the hemolyzed Red Blood Cells, but then we start to see it as high even on T2. Late remains of the hemorrhage on MR can be seen as a rim of Hemosiderin deposits – that is just black. Gradient Echo (T2*) (GRE) sequences show hemorrhage as black since it is a sort of susceptibility artefact. It also exaggerates the volume of bleeding (“blooming artefact”).

Hemorrhagic Choroid Plexus Cyst
Late Subacute Hemorrhage on DWI
Hemorrhagic Brain Metastases

 

 

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