Neuroradiologic differential diagnosis of cerebral intraparenchymal hemorrhage.
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| Title: | Neuroradiologic differential diagnosis of cerebral intraparenchymal hemorrhage. |
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| Authors: | Anzalone, N., Scotti, R., Riva, R. |
| Source: | Neurological Sciences. Mar2004 Supplement 1, Vol. 25, ps3-s5. 1p. |
| Subjects: | Intracerebral hematoma, Blood-brain barrier disorders, Magnetic resonance imaging, Hemoglobins, Hemosiderin, Edema |
| Abstract: | Cerebral intraparenchymal hematoma (IH) is one of the most common causes of sudden onset of focal neurologic deficit. This is particularly true in the acute phase, in which IH appears hyperdense compared to the cerebral tissue. By three to four weeks, it becomes isodense with the cerebral gray matter and hypodense within 2 to 6 months. After contrast media administration, IH shows a peripheral ring of enhancement owing to the breakdown of the blood brain barrier. On magnetic resonance imaging (MRI), the appearance of IH depends upon the paramagnetic effects of the different derivates of hemoglobin and both the magnetic field strength and type of sequences used. In the hyperacute phase, IH appears hyperintense on T2 and hypointense on T1 owing to the presence of oxyhemoglobin. In the acute phase, IH is hypointense on T2 and iso-hypointense on T1 as a consequence of the presence of deoxyhemoglobin, which is converted into methemoglobin by 3 to 5 days. Methemoglobin has a strong paramagnetic effect, so in this phase IH becomes hyperintense on T1 and hypointense on T2. After 2 weeks, methemoglobin is converted in hemosiderin, responsible of the ring of hypointensity surrounding the lesion on T2WI. When an IH has been diagnosed, someone should think about the origin of bleeding. Among the different differential diagnosis, one should think about the possible origin, taking into account some parameters, such as: anamnestic data, site of the lesion, number of lesions, appearance on CT and MRI, and presence of perilesional edema. Computed tomography is a reliable and very fast tool for the diagnosis of IH, but MRI is able to provide additional information about the spontaneous or secondary nature of the hematoma, thus allowing a better characterization of the hemorrhagic lesion. [ABSTRACT FROM AUTHOR] |
| Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 12632618 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Neuroradiologic differential diagnosis of cerebral intraparenchymal hemorrhage. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Anzalone%2C+N%2E%22">Anzalone, N.</searchLink><br /><searchLink fieldCode="AR" term="%22Scotti%2C+R%2E%22">Scotti, R.</searchLink><br /><searchLink fieldCode="AR" term="%22Riva%2C+R%2E%22">Riva, R.</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Mar2004 Supplement 1, Vol. 25, ps3-s5. 1p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Intracerebral+hematoma%22">Intracerebral hematoma</searchLink><br /><searchLink fieldCode="DE" term="%22Blood-brain+barrier+disorders%22">Blood-brain barrier disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging%22">Magnetic resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Hemoglobins%22">Hemoglobins</searchLink><br /><searchLink fieldCode="DE" term="%22Hemosiderin%22">Hemosiderin</searchLink><br /><searchLink fieldCode="DE" term="%22Edema%22">Edema</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Cerebral intraparenchymal hematoma (IH) is one of the most common causes of sudden onset of focal neurologic deficit. This is particularly true in the acute phase, in which IH appears hyperdense compared to the cerebral tissue. By three to four weeks, it becomes isodense with the cerebral gray matter and hypodense within 2 to 6 months. After contrast media administration, IH shows a peripheral ring of enhancement owing to the breakdown of the blood brain barrier. On magnetic resonance imaging (MRI), the appearance of IH depends upon the paramagnetic effects of the different derivates of hemoglobin and both the magnetic field strength and type of sequences used. In the hyperacute phase, IH appears hyperintense on T2 and hypointense on T1 owing to the presence of oxyhemoglobin. In the acute phase, IH is hypointense on T2 and iso-hypointense on T1 as a consequence of the presence of deoxyhemoglobin, which is converted into methemoglobin by 3 to 5 days. Methemoglobin has a strong paramagnetic effect, so in this phase IH becomes hyperintense on T1 and hypointense on T2. After 2 weeks, methemoglobin is converted in hemosiderin, responsible of the ring of hypointensity surrounding the lesion on T2WI. When an IH has been diagnosed, someone should think about the origin of bleeding. Among the different differential diagnosis, one should think about the possible origin, taking into account some parameters, such as: anamnestic data, site of the lesion, number of lesions, appearance on CT and MRI, and presence of perilesional edema. Computed tomography is a reliable and very fast tool for the diagnosis of IH, but MRI is able to provide additional information about the spontaneous or secondary nature of the hematoma, thus allowing a better characterization of the hemorrhagic lesion. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s10072-004-0205-8 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 1 StartPage: s3 Subjects: – SubjectFull: Intracerebral hematoma Type: general – SubjectFull: Blood-brain barrier disorders Type: general – SubjectFull: Magnetic resonance imaging Type: general – SubjectFull: Hemoglobins Type: general – SubjectFull: Hemosiderin Type: general – SubjectFull: Edema Type: general Titles: – TitleFull: Neuroradiologic differential diagnosis of cerebral intraparenchymal hemorrhage. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Anzalone, N. – PersonEntity: Name: NameFull: Scotti, R. – PersonEntity: Name: NameFull: Riva, R. IsPartOfRelationships: – BibEntity: Dates: – D: 02 M: 03 Text: Mar2004 Supplement 1 Type: published Y: 2004 Identifiers: – Type: issn-print Value: 15901874 Numbering: – Type: volume Value: 25 Titles: – TitleFull: Neurological Sciences Type: main |
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