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Intracerebral hemorrhage diagnosis

Neuroimaging is indispensable for the rapid diagnosis of intracerebral hemorrhage (ICH) and identification of the underlying etiology, thus facilitating triage and appropriate treatment of patients. The most common neuroimaging modalities include noncontrast computed tomography (CT), CT angiography (CTA), digital subtraction angiography, and magnetic resonance imaging (MRI). Novel technologies such as dual-energy CT/CTA, rapid MRI techniques, near-infrared spectroscopy, and automated ICH detection hold promise for faster pre- and in-hospital ICH diagnosis that may impact patient management 1).

Computed tomography

Intracerebral hemorrhage computed tomography.


Spontaneous intracerebral hemorrhage MRI.

Catheter cerebral angiography

For diagnosing ICH itself, angiography cannot reliably differentiate the mass effect from an ICH from that due to an ischemic infarct or tumor.

May demonstrate AVMs and aneurysms when they are associated with the ICH. The yield may be increased by delaying the study.

May demonstrate vascular blush in some cases of tumor. Normal arteriography cannot eliminate cerebral amyloid angiopathy as the etiology of ICH in the elderly.

CTA has supplanted most indications for catheter angiography.


Results indicated that circulating miR-181b, miR-223, miR-155 and miR-145 in plasma samples could be served as a potential noninvasive tool in ICH detection 2).


Rindler RS, Allen JW, Barrow JW, Pradilla G, Barrow DL. Neuroimaging of Intracerebral Hemorrhage. Neurosurgery. 2020 May 1;86(5):E414-E423. doi: 10.1093/neuros/nyaa029. PubMed PMID: 32109294.
Gareev I, Yang G, Sun J, Beylerli O, Chen X, Zhang D, Zhao B, Zhang R, Sun Z, Yang Q, Li L, Pavlov V, Safin S, Zhao S. Circulating MicroRNAs as a Potential Non-invasive Biomarkers of Spontaneous Intracerebral Hemorrhage. World Neurosurg. 2019 Sep 13. pii: S1878-8750(19)32446-5. doi: 10.1016/j.wneu.2019.09.016. [Epub ahead of print] PubMed PMID: 31525485.
intracerebral_hemorrhage_diagnosis.txt · Last modified: 2020/05/04 17:34 by administrador