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: University of Helsinki, HUS Medical Imaging Center
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, HUS Neurocenter
University of Helsinki, Neurologian yksikkö
University of Helsinki, HUS Medical Imaging Center
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

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