Journal article
Analysis of the utility of early MRI/MRA in 400 patients with spontaneous intracerebral hemorrhage
Journal of neurosurgery, Vol.132(6), pp.1865-1871
06/2020
DOI: 10.3171/2019.2.JNS183425
PMID: 31151101
Abstract
OBJECTIVEMRI and MRA studies are routinely obtained to identify the etiology of intracerebral hemorrhage (ICH). The diagnostic yield of MRI/MRA in the setting of an acute ICH, however, remains unclear. The authors’ goal was to determine the utility of early MRI/MRA in detecting underlying structural lesions in ICH and to identify patients in whom additional imaging during hospitalization could safely be foregone.METHODSThe authors reviewed data obtained in 400 patients with spontaneous ICH diagnosed on noncontrast head CT scans who underwent MRI/MRA between 2015 and 2017 at their institution. MRI/MRA studies were reviewed to identify underlying lesions, such as arteriovenous malformations, aneurysms, cavernous malformations, arteriovenous fistulas, tumors, sinus thrombosis, moyamoya disease, and abscesses.RESULTSThe median patient age was 65 ± 15.8 years. Hypertension was the most common (72%) comorbidity. Structural abnormalities were detected on MRI/MRA in 12.5% of patients. Structural lesions were seen in 5.7% of patients with basal ganglia/thalamic ICH, 14.1% of those with lobar ICH, 20.4% of those with cerebellar ICH, and 27.8% of those with brainstem ICH. Notably, the diagnostic yield of MRI/MRA was 0% in patients > 65 years with a basal ganglia/thalamic hemorrhage and 0% in those > 85 years with any ICH location, whereas it was 37% in patients < 50 years and 23% in those < 65 years. Multivariate analysis showed that decreasing age, absence of hypertension, and non–basal ganglia/thalamic location were predictors of finding an underlying lesion.CONCLUSIONSThe yield of MRI/MRA in ICH is highly variable, depending on patient age and hemorrhage location. The findings of this study do not support obtaining early MRI/MRA studies in patients ≥ 65 years with basal ganglia/thalamic ICH or in any ICH patients ≥ 85 years. In all other situations, early MRI/MRA remains valuable in ruling out underlying lesions.
Details
- Title: Subtitle
- Analysis of the utility of early MRI/MRA in 400 patients with spontaneous intracerebral hemorrhage
- Creators
- Nohra Chalouhi - Departments of 1Neurosurgery andNikolaos Mouchtouris - Departments of 1Neurosurgery andFadi Al Saiegh - Departments of 1Neurosurgery andSomnath Das - Departments of 1Neurosurgery andAhmad Sweid - Departments of 1Neurosurgery andAdam E Flanders - 2Radiology, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaRobert M Starke - 3Department of Neurosurgery and Radiology, Miami Miller School of Medicine, Miami University Hospital, Miami, Florida; andMichael P Baldassari - Departments of 1Neurosurgery andStavropoula Tjoumakaris - Departments of 1Neurosurgery andMichael Reid Gooch - Departments of 1Neurosurgery andSyed Omar Shah - Departments of 1Neurosurgery andDavid Hasan - 4Department of Neurosurgery, University of Iowa, Iowa City, IowaNabeel Herial - Departments of 1Neurosurgery andRobin D’Ambrosio - Departments of 1Neurosurgery andRobert Rosenwasser - Departments of 1Neurosurgery andPascal Jabbour - Departments of 1Neurosurgery and
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery, Vol.132(6), pp.1865-1871
- DOI
- 10.3171/2019.2.JNS183425
- PMID
- 31151101
- ISSN
- 0022-3085
- eISSN
- 1933-0693
- Language
- English
- Date published
- 06/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040289402771
Metrics
33 Record Views