A Pictorial Review of Intracranial Haemorrhage Revisited.
Adult
Aged
Aged, 80 and over
Amyloidosis
/ complications
Brain Neoplasms
/ complications
Cerebral Hemorrhage
/ diagnostic imaging
Decision Trees
Female
Humans
Intracranial Arteriovenous Malformations
/ complications
Intracranial Hemorrhage, Hypertensive
/ diagnostic imaging
Male
Middle Aged
Neuroimaging
/ methods
Tomography, X-Ray Computed
Venous Thrombosis
/ complications
Intracerebral haemorrhage
amyloid angiopathy
herpes encephalitis
hypertensive haemorrhage
vascular malformations
vasculitis
venous sinus thrombosis
Journal
Current medical imaging reviews
Titre abrégé: Curr Med Imaging Rev
Pays: United Arab Emirates
ID NLM: 101272516
Informations de publication
Date de publication:
Historique:
received:
09
04
2018
revised:
02
05
2018
accepted:
20
05
2018
entrez:
4
2
2020
pubmed:
6
2
2020
medline:
31
10
2020
Statut:
ppublish
Résumé
The many causes of Intracerebral Haemorrhage (IH) can be difficult to differentiate. However, there are imaging features that can provide useful clues. This paper aims to provide a pictorial review of the common causes of IH, to identify some distinguishing diagnostic features and to provide guidance on subsequent imaging and follow up. It is hoped that this review would benefit radiology and non-radiology consultants, multi-professional workers and trainees who are commonly exposed to unenhanced CT head studies but are not neuroradiology specialists. In the absence of trauma, Spontaneous Intracerebral Haemorrhage (SIH) can be classified as idiopathic or secondary. Secondary causes of IH include hypertension and amyloid angiopathy (75-80%) and less common pathologies such as vascular malformations (arteriovenous malformations, aneurysms and cavernomas), malignancy , venous sinus thrombosis and infection. SIH causes between 10 to 15% of all strokes and has a higher mortality than ischaemic stroke. Trauma is another cause of IH with significant mortality and some of the radiological features will be reviewed. Unenhanced CT is a mainstay of acute phase imaging due to its availability and, sensitivity and specificity for detecting acute haemorrhage. Several imaging features can be identified on CT and, along with clinical information, can provide some certainty in diagnosis. For those suitable and where diagnostic uncertainty remains CT angiogram, time-resolved CT angiography and catheter angiography can help identify underlying AVMs, aneurysms, cavernomas and vasculitides. MRI is more sensitive for the detection of subacute and chronic haemorrhage and identification of underlying mass lesions.
Sections du résumé
BACKGROUND
BACKGROUND
The many causes of Intracerebral Haemorrhage (IH) can be difficult to differentiate. However, there are imaging features that can provide useful clues. This paper aims to provide a pictorial review of the common causes of IH, to identify some distinguishing diagnostic features and to provide guidance on subsequent imaging and follow up. It is hoped that this review would benefit radiology and non-radiology consultants, multi-professional workers and trainees who are commonly exposed to unenhanced CT head studies but are not neuroradiology specialists.
DISCUSSION
CONCLUSIONS
In the absence of trauma, Spontaneous Intracerebral Haemorrhage (SIH) can be classified as idiopathic or secondary. Secondary causes of IH include hypertension and amyloid angiopathy (75-80%) and less common pathologies such as vascular malformations (arteriovenous malformations, aneurysms and cavernomas), malignancy , venous sinus thrombosis and infection. SIH causes between 10 to 15% of all strokes and has a higher mortality than ischaemic stroke. Trauma is another cause of IH with significant mortality and some of the radiological features will be reviewed.
CONCLUSION
CONCLUSIONS
Unenhanced CT is a mainstay of acute phase imaging due to its availability and, sensitivity and specificity for detecting acute haemorrhage. Several imaging features can be identified on CT and, along with clinical information, can provide some certainty in diagnosis. For those suitable and where diagnostic uncertainty remains CT angiogram, time-resolved CT angiography and catheter angiography can help identify underlying AVMs, aneurysms, cavernomas and vasculitides. MRI is more sensitive for the detection of subacute and chronic haemorrhage and identification of underlying mass lesions.
Identifiants
pubmed: 32008532
pii: CMIR-EPUB-90703
doi: 10.2174/1573405614666180528080436
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
853-865Informations de copyright
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