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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Article number117434
JournalJournal of the Neurological Sciences
Volume425
DOIs
StatePublished - Jun 15 2021

Keywords

  • DWI lesions
  • Intracerebral hemorrhage
  • Timing

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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