Neuroradiology

, Volume 36, Issue 6, pp 422–425 | Cite as

The value of MRI in angiogram-negative intracranial haemorrhage

  • S. A. Renowden
  • A. J. Molyneux
  • P. Anslow
  • J. V. Byrne
Diagnostic Neuroradiology

Abstract

In one year, cerebral angiograms were performed for intracranial haemorrhage (ICH) on 334 patients. No cause for haemorrhage could be identified in 41 (12%), 30 of whom had predominantly subarachnoid (SAH) and 11 predominantly parenchymal haemorrhage (PH). These patients were prospectively examined by cranial MRI 1–6 weeks after the ictus. The MRI studies were positive in 7 patients (17%). In the 30 patients examined after SAH, 2 studies were positive, showing an aneurysm in one case and a brain stem lesion of uncertain actiology in the other. In those examined after PH, cavernous angiomas were shown in 2, a tumour in 1 and a vascular malformation in another; useful diagnostic information was thus obtained in 36% of this group.

Key words

MRI Angiogram negative intracranial haemorrhage 

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References

  1. 1.
    Bjorkesten G, Halonen V (1965) Incidence of intracranial vascular lesions in patients with subarachnoid hemorrhage investigated by four-vessel angiography. J Neurosurg 23:29–32Google Scholar
  2. 2.
    Sutton D (1962) Arteriography. Livingstone, Edinburgh, pp viii, 321Google Scholar
  3. 3.
    West HH, Mani RL, Eisenberg RL (1977) Normal cerebral arteriography in patients with spontaneous subarachnoid hemorrhage. Neurology 27:592–594Google Scholar
  4. 4.
    Forster DM, Steiner L, Hakanson S, Bergvall U (1978) The value of repeat panangiography in cases of unexplained subarachnoid hemorrhage. J Neurosurg 48:712–716Google Scholar
  5. 5.
    Beguelin C, Seiler R (1983) Subarachnoid hemorrhage with normal cerebral panangiography. Neurosurgery 13:409–411Google Scholar
  6. 6.
    Nishioka H, Torner JC, Graf CJ (1984) Cooperative study of intracranial aneurysms and subarachnoid hemorrhage: a long term prognostic study. III. Subarachnoid hemorrhage of undetermined origin. Arch Neurol 41:1147–1151Google Scholar
  7. 7.
    Shephard RD (1984) Prognosis of spontaneous (non-traumatic) subarachnoid hemorrhage of unknown cause. Lancet i:777–779Google Scholar
  8. 8.
    Juul R, Torbjorn AF, Ringkjob R (1986) Prognosis in subarachnoid hemorrhage of unknown etiology. J Neurosurg 64: 359–362Google Scholar
  9. 9.
    Susuki S, Kayama T, Sakurai Y (1987) Subarachnoid hemorrhage of unknown cause. Neurosurgery 21:310–313Google Scholar
  10. 10.
    Kassell NF, Torner JC, Jane JA, Haley EC, Adams HP (1990) The international cooperative study on the timing of aneurysm surgery. Part 2: Surgical results. J Neurosurg 73:37–47Google Scholar
  11. 11.
    Eskesen V, Sorensen EB, Rosenorn J, Schmidt K (1984) The prognosis in subarachnoid hemorrhage of unknown etiology. J Neurosurg 61:1029–1031Google Scholar
  12. 12.
    Brismar J, Sundbarg G (1985) Subarachnoid hemorrhage of unknown origin: prognosis and prognostic factors. J Neurosurg 63: 349–354Google Scholar
  13. 13.
    Rinkel GJE, Wijdicks EFM, Vermeulen M, Hageman LM, Tans JHT, van Gijn J (1990) Outcome in perimesencephalic (nonaneurysmal) subarachnoid hemorrhage. Neurology 40:1130–1132Google Scholar
  14. 14.
    Oder W, Kollegger H, Zeiler K, Dal-Bianco P, Wessely P, Deecke L (1991) Subarachnoid hemorrhage of unknown aetiology: early prognostic factors for long-term functional capacity. J Neurosurg 74:601–605Google Scholar
  15. 15.
    Hayward RD (1977) Subarachnoid hemorrhage of unknown aetiology. A clinical and radiological study of 51 cases. J Neurol Neurosurg Psychiatry 40:926–931Google Scholar
  16. 16.
    Alexander MSM, Dias PS, Uttley D (1986) Spontaneous subarachnoid haemorrhage and negative cerebral panangiography. J Neurosurg 64:537–542Google Scholar
  17. 17.
    Van Gijn J, van Dongen KJ, Vermeulen M, Hijdra A (1985) Perimesencephalic hemorrhage: a nonaneurysmal and benign form of subarachnoid hemorrhage. Neurology 35:493–497Google Scholar
  18. 18.
    Rinkel GJE, Wijdicks EFM, Vermeulen M, Ramos LMP, Tanghe HLJ, Hasan D, Van Gijn J (1991) Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture. AJNR 12:829–834Google Scholar
  19. 19.
    Ojemann RG, Heros RC (1983) Spontaneous brain hemorrhage. Stroke 14:468–475Google Scholar
  20. 20.
    Kramer RA, Wing SD (1977) CT of angiographically occult cerebral vascular malformations. Radiology 123:649–652Google Scholar
  21. 21.
    Scott M (1975) Spontaneous intracerebral haematoma caused by cerebral neoplasm: report of eight verified cases. J Neurosurg 42:338–342Google Scholar
  22. 22.
    Mandybur TI (1977) Intracranial haemorrhage caused by metastatic tumours. Neurology 27:650–655Google Scholar
  23. 23.
    Leeds NE, Elkin CM, Zimmerman RD (1984) Gliomas of the brain. Sem Roentgenol 19:27–43Google Scholar
  24. 24.
    Little JR, Dial B, Belanger G, Carpenter S (1979) Brain haemorrhage from intracranial tumour. Stroke 10:283–288Google Scholar
  25. 25.
    Zülch KJ (1986) Brain tumours: their biology and pathology, 3rd edn. Springer, Berlin, Heidelberg New YorkGoogle Scholar
  26. 26.
    Atlas SW, Grossman RI, Gomori JM, Hackney DB, Goidberg HI, Zimmerman RA, Bilaniuk LT (1987) Hemorrhagic intracranial malignant neoplasms: spin echo imaging. Radiology 164:71–77Google Scholar
  27. 27.
    Destian S, Sze G, Krol G, Zimmerman RD, Deck MDE (1989) MR imaging of hemorrhagic intracranial neoplasms. AJR 152: 137–144Google Scholar
  28. 28.
    Russell DS, Rubinstein LJ (1989) Pathology of tumours of the nervous system, 5th edn. Edward Arnold, London, pp 727–746Google Scholar
  29. 29.
    Sarwar M, McCormick WF (1978) Intracerebral venous angioma. Arch Neurol 35:323–325Google Scholar
  30. 30.
    Rigamonti D, Hadley MN, Drayer BP, Johnson PC, Hoenig-Rigamonti K, Knight JT, Spetzler RF (1988) Cerebral cavernous malformations. New Engl J Med 319:343–347Google Scholar
  31. 31.
    Mason I, Aase JM, Orrison WW, Wicks JD, Seigel RS, Bicknell JM (1988) Familial cavernous angiomas of the brain in an Hispanic family. Neurology 38:324–326Google Scholar
  32. 32.
    Jellinger K (1986) Vascular malformations of the central nervous system: a morphological overview. Neurosurg Rev 9:177–216Google Scholar
  33. 33.
    Robinson JR, Iwad IA, Little JR (1991) Natural history of the cavernous angioma. J Neurosurg 75:709–714Google Scholar
  34. 34.
    Hennig J, Naureth A, Friedburg H (1986) RARE imaging: a fast imaging method for clinical MRI. Magn Reson Med 3:823–833Google Scholar
  35. 35.
    Jones K, Mulkern RV, Mantello MT, Melki PS, Ahn SS, Barnes PD, Jolesz FA (1992) Brain hemorrhage: evaluation with fast spin-echo and conventional dual spin-echo images. Radiology 182:53–58Google Scholar
  36. 36.
    Norbash AM, Glover GH, Enzmann DR (1992) Intracerebral lesion contrast with spin-echo and fast spin-echo pulse sequences. Radiology 185:661–665Google Scholar
  37. 37.
    Atlas SW, Mark AS, Grossman RI, Gomori JM (1988) Intracranial haemorrhage: gradient-echo MR imaging at 1.5 Tesla. Comparison with spin-echo imaging and clinical applications. Radiology 168:803–807Google Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • S. A. Renowden
    • 1
  • A. J. Molyneux
    • 1
  • P. Anslow
    • 1
  • J. V. Byrne
    • 1
  1. 1.Department of NeuroradiologyRadeliffe InfirmaryOxfordUK

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