CT and MRI scans of hyperacute intracerebral hemorrhage

CT and MRI studies were obtained less than six hours from symptom onset in a patient with spontaneous acute intracerebral hemorrhage. The CT scan shows a hyperdense hemorrhage predominantly in the left frontal lobe. On MRI, the central portion of the hematoma is isointense to brain parenchyma on the T1-weighted image and hyperintense on the T2-weighted and T2* gradient echo images, consistent with hemorrhage containing oxyhemoglobin. On the T2-weighted and T2* gradient echo images, the periphery of the hemorrhage is hypointense, consistent with deoxygenation that occurs more rapidly at the borders. On the T2 weighted image, tissue adjacent to and surrounding the hematoma is hyperintense, consistent with vasogenic edema.