Timing of diffusion weighted imaging lesions in spontaneous intracerebral hemorrhage

Rajeev K Garg; Mohammad Alberawi; Bichun Ouyang; Sayona John; Ivan Da Silva; Starane Shepherd; Mehmet Kocak; Sudeep Bhabad; Deborah A Hall; Miral D Jhaveri; Thomas P Bleck

doi:10.1016/j.jns.2021.117434

Timing of diffusion weighted imaging lesions in spontaneous intracerebral hemorrhage

J Neurol Sci. 2021 Jun 15:425:117434. doi: 10.1016/j.jns.2021.117434. Epub 2021 Apr 3.

Authors

Affiliations

¹ Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street, POB 1106, Chicago, IL 60126, USA. Electronic address: [email protected].
² Department of Radiological Sciences, University of Oklahoma Health Sciences Center, 940 NE 13th Street, Suite 3G3210, Oklahoma City, OK 73104, USA. Electronic address: [email protected].
³ Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street, POB 1106, Chicago, IL 60126, USA. Electronic address: [email protected].
⁴ Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street, POB 1106, Chicago, IL 60126, USA. Electronic address: [email protected].
⁵ Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street, POB 1106, Chicago, IL 60126, USA. Electronic address: [email protected].
⁶ Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street, POB 1106, Chicago, IL 60126, USA. Electronic address: [email protected].
⁷ Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, 1620 West Harrison Street, Third Floor, Chicago, IL 60612, USA. Electronic address: [email protected].
⁸ Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, 1620 West Harrison Street, Third Floor, Chicago, IL 60612, USA. Electronic address: [email protected].
⁹ Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street, POB 1106, Chicago, IL 60126, USA. Electronic address: [email protected].
¹⁰ Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, 1620 West Harrison Street, Third Floor, Chicago, IL 60612, USA. Electronic address: [email protected].
¹¹ Davee Department of Neurology, Northwestern University, 625 North Michigan Avenue, Suite 1150, Chicago, IL, USA. Electronic address: [email protected].

PMID: 33838500
DOI: 10.1016/j.jns.2021.117434

Abstract

Introduction: Diffusion weighted imaging (DWI) lesions are common after spontaneous intracerebral hemorrhage (sICH). However, their timing relative to a patient's admission to the hospital is unknown. The purpose of this study is to estimate the timing of new DWI lesions after admission for acute sICH.

Material and methods: Select patients enrolled in a single center prospective study examining the prevalence DWI lesions in acute primary sICH received two MRI scans of the brain after admission. The presence of a new DWI lesion between MRI scans was defined as a new DWI event. A lognormal parametric model was used to estimate the median time (50% percentile) to develop a new DWI lesion.

Results: Among the 121 participants enrolled in the study, 63 (52%) had two brain MRIs. The median time from admission to 1st MRI was 1 day (IQR 1.2, range 0.1-8.4). The median time between the 2 MRI scans was 2.1 (IQR 2.9, range 0.02-17.4) days. 30.2% (n = 19) of participants developed a new DWI lesion between MRI scans. The estimated median time from 1st MRI to new DWI event was 6.3 days (95% CI, 4.1 to 9.6).

Discussion and conclusion: Accounting for time from admission to 1st MRI, we found that 50% of new DWI lesions occurred by 7.3 days after sICH admission. Pathophysiologic changes in sICH during this time frame need to be studied in order to elucidate a mechanism for DWI lesions.

Keywords: DWI lesions; Intracerebral hemorrhage; Timing.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brain / diagnostic imaging
Brain Ischemia*
Cerebral Hemorrhage* / diagnostic imaging
Diffusion Magnetic Resonance Imaging
Humans
Prospective Studies