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Cerebrovascular Disorders

  • Koreaki Mori

Abstract

Changes in red blood cell hemoglobin are reflected as changes in signal intensity on MRI, thereby allowing chronological changes in intracerebral hematomas to be easily detected. Immediately after a hemorrhage, there is an accumulation of oxyhemoglobin which is converted into deoxyhemoglobin. Oxyhemoglobin does not influence the relaxation time of hydrogen ions, but deoxyhemoglobin shortens it. Consequently, within the first few hours of a hemorrhage, a hematoma is shown with the same signal intensity as gray matter in both T1 and T2 weighted images. The low signal area at the periphery of the hematoma seen in a T1, weighted image (shown as a high signal intensity on T2) is thought to represent serum. Two to three days after the hemorrhage, a partially high intensity area may be seen on T1, due to the presence of deoxyhemoglobin, but in the T2 weighted image, the whole area is seen as a low signal intensity. From about the first week after the hemorrhage, hemolysis commences from the periphery, with oxidation of deoxyhemoglobin and its conversion into methemoglobin. Both in the T1 and T2 weighted images, the hematoma passes through the stage of iso intensity until the periphery becomes a high signal intensity area on T1 and gradually spreads centrally. The accompanying liquefaction of the hematoma which proceeds from the periphery towards the center is also gradually shown as a high signal intensity on T2. Formation of a hematoma capsule starts from 2–3 weeks after the hemorrhage. Methemoglobin is phagocytosed by macrophages and converted into hemosiderin, which also shortens the relaxation time. In a T1, weighted image, the uniformly high signal intensity area changes into a low signal intensity; on T2, liquefaction of hematoma is seen as a homogeneously high signal intensity area, and linear low signal areas appear at the periphery of the hematoma. Several months after a hemorrhage, the hematoma undergoes scar formation which is also seen as a low intensity area.

Keywords

High Signal Intensity Moyamoya Disease Cerebrovascular Disorder Normal Pressure Hydrocephalus Cavernous Angioma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Tokyo 1991

Authors and Affiliations

  • Koreaki Mori
    • 1
  1. 1.Department of NeurosurgeryKochi Medical SchoolKohasu, Okoh-cho, Nankoku, Kochi, 783Japan

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