Imaging: blood within cerebral parenchyma, if etiology is uncertain perform MRI and MRA or CTA to look for vascular causes
Complications: herniation
Treatment: evacuation of clot
Imaging evolution of intracerebral hemorrhage evolution on MRI: — Note: this is most commonly used to date subdural hematomas
Age
State
T1WI
T2WI
< 1 day
OxyHb
Iso
Bright
Hyperacute
1-3 days
DeOxyHb
Iso
Dark
Acute
3-7 days
IntracellularMetHb
Bright
Dark
Early Subacute
1-3 weeks
ExtracellularMetHb
Bright
Bright
Late Subacute
> 3 weeks
Hemosiderin
Dark
Dark
Chronic
Cases of Intracerebral Hemorrhage
Coronal US of the brain (below) shows echogenic material in right subdural space. Coronal and sagittal US of the brain (above) shows a right parietal round mixed echogenicity lesion.Axial CT without contrast of the brain shows mixed-density fluid in the left lateral ventricle posteriorly and mixed-density fluid in the left parietal-occipital lobe. There is also diffuse prominence of the sulci and ventricular system.Coronal and sagittal US of the brain shows a large, round echogenic lesion in the left parietal lobe.Sagittal, coronal and axial CT without contrast of the brain shows a large, round high density lesion in the right parietal lobe.