MRI Characterization of Non-traumatic Intracerebral Hemorrhage in Young Adults

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Elmegiri , M , Koivunen , R-J , Tatlisumak , T , Putaala , J & Martola , J 2020 , ' MRI Characterization of Non-traumatic Intracerebral Hemorrhage in Young Adults ' , Frontiers in neurology , vol. 11 , 558680 .

Title: MRI Characterization of Non-traumatic Intracerebral Hemorrhage in Young Adults
Author: Elmegiri, Mohamed; Koivunen, Riku-Jaakko; Tatlisumak, Turgut; Putaala, Jukka; Martola, Juha
Contributor organization: HUS Medical Imaging Center
Department of Diagnostics and Therapeutics
University of Helsinki
Helsinki University Hospital Area
Anestesiologian yksikkö
HUS Emergency Medicine and Services
HUS Neurocenter
Neurologian yksikkö
Date: 2020-10-29
Language: eng
Number of pages: 9
Belongs to series: Frontiers in neurology
ISSN: 1664-2295
Abstract: Background and Purpose: Non-traumatic intracerebral hemorrhage (ICH) in younger population is a relatively rare event but is associated with considerable mortality and poor functional outcome. Imaging plays a crucial role in determining the underlying cause and guide treatment of ICH. In up to 41% of patients in prior studies, the underlying cause remained elusive. However, the usage of MRI as part of diagnostic work-up was scanty. We aimed to analyze MRI findings of ICH in younger patients and assess specificity and sensitivity of MRI in detecting structural or local underlying causes of ICH.Methods: We included patients aged 15–49 years with first-ever ICH identified from a prospective hospital discharge registry, 2000–2010. All study patients underwent MRI within 3 months of ICH. Imaging data was analyzed by a senior neuroradiologist blinded to final clinical diagnosis. We calculated the diagnostic accuracy of MRI in detecting structural/local underlying causes.Results: Of our 116 patients (median age, 39; 67% males), structural/local causes were the leading causes of ICH (50.0%), and of these, bleeding cavernomas (23.3%) were the most frequent followed by arteriovenous malformations (12.9%), cerebral venous thrombosis (CVT) (7.8%), brain tumors (5.2%), and moyamoya disease (0.9%). Lobar location of ICH was more prevalent in younger patients. MRI was highly sensitive (90.0%; 95% confidence interval, 79.5–96.2%) for detection of structural/local causes compared with angiographic imaging (55.6%; 95% CI, 40.0–70.4%), while MRI was less specific (87.3%; 95% CI, 75.5–94.7%) for structural/local causes, compared with angiographic imaging (97.4%; 95% CI, 86.5–99.9%).Conclusion: MRI was highly sensitive for the detection of structural and local causes underlying ICH in young adults. Thus, MRI should be considered in the diagnostic work-up of all young ICH patients to enable targeted secondary prevention.
Subject: 3124 Neurology and psychiatry
spontaneous intracerebral hemorrhage
young adults
magnetic resonance imaging
structural cause
3112 Neurosciences
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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