{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:00:41Z","timestamp":1792652441015,"version":"4.5.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1999,11]]},"abstract":"\n Background and Purpose<\/jats:italic>\n \u2014MRI has been increasingly used in the evaluation of acute stroke patients. However, MRI must be able to detect early hemorrhage to be the only imaging screen used before treatment such as thrombolysis. Susceptibility-weighted imaging, an echo-planar T2* sequence, can show intracerebral hemorrhage (ICH) in patients imaged between 2.5 and 5 hours from symptom onset. It is unknown whether MRI can detect ICH earlier than 2.5 hours. We describe 5 patients with ICH who had MRI between 23 and 120 minutes from symptom onset and propose diagnostic patterns of evolution of hyperacute ICH on MRI.\n <\/jats:p>\n \n Methods<\/jats:italic>\n \u2014As part of our acute imaging protocol, all patients with acute stroke within 24 hours from symptom onset were imaged with a set of sequences that included susceptibility-weighted imaging, diffusion- and perfusion-weighted imaging, T1- and T2-weighted imaging, fluid-attenuated inversion recovery (FLAIR), and MR angiography using echo-planar techniques. Five patients with ICH had MRI between 23 and 120 minutes from the onset of symptoms.\n <\/jats:p>\n \n Results<\/jats:italic>\n \u2014ICH was identified in all patients. Distinctive patterns of hyperacute ICH and absence of signs of ischemic stroke were the hallmark features of this diagnosis. The hyperacute hematoma appears to be composed of 3 distinct areas: (1) center: isointense to hyperintense heterogeneous signal on susceptibility-weighted and T2-weighted imaging; (2) periphery: hypointense (susceptibility effect) on susceptibility-weighted and T2-weighted imaging; and (3) rim: hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging, representing vasogenic edema encasing the hematoma.\n <\/jats:p>\n \n Conclusions<\/jats:italic>\n \u2014MRI is able to detect hyperacute ICH and show a pattern of evolution of the hematoma within 2 hours from the onset of symptoms.\n <\/jats:p>","DOI":"10.1161\/01.str.30.11.2263","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"2263-2267","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":216,"title":["MRI Features of Intracerebral Hemorrhage Within 2 Hours From Symptom Onset"],"prefix":"10.1161","volume":"30","author":[{"given":"Italo","family":"Linfante","sequence":"first","affiliation":[{"name":"From the Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Mass (I.L., R.H.L., L.R.C.), and Section of Stroke Diagnostics and Therapeutics, Stroke Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md (S.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael H.","family":"Llinas","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Mass (I.L., R.H.L., L.R.C.), and Section of Stroke Diagnostics and Therapeutics, Stroke Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md (S.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis R.","family":"Caplan","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Mass (I.L., R.H.L., L.R.C.), and Section of Stroke Diagnostics and Therapeutics, Stroke Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md (S.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Warach","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Mass (I.L., R.H.L., L.R.C.), and Section of Stroke Diagnostics and Therapeutics, Stroke Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md (S.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332401"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004647-199806000-00001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.165.1.3628771"},{"key":"e_1_3_2_4_2","first-page":"193","volume":"7","year":"1988","unstructured":"Atlas SW, Mark AS, Grossman RI, Gomori JM. Intracranial hemorrhage: gradient-echo MR imaging at 1.5T: comparison with spin-echo imaging and clinical applications. Radiology. 1988;7:193\u2013199.","journal-title":"Radiology"},{"key":"e_1_3_2_5_2","first-page":"899","volume":"12","year":"1991","unstructured":"Hayman LA, Taber KH, Ford JJ, Bryan RN. Mechanisms of MR signal alteration by acute intracerebral blood: old concepts and new theories: AJNR Am J Neuroradiol. 1991;12:899\u2013907.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.189.1.8372185"},{"key":"e_1_3_2_7_2","first-page":"751","volume":"7","year":"1986","unstructured":"Edelman RR, Johnson K, Buxton R, Shoukimas G, Rosen BR, Davis KR, Brady TJ. MR of hemorrhage: a new approach. AJNR Am J Neuroradiol. 1986;7:751\u2013756.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.27.12.2321"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.30.4.765"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1987.66.4.0555"},{"key":"e_1_3_2_11_2","first-page":"1471","volume":"19","year":"1998","unstructured":"Atlas SW, Thulborn KR. MR detection of hyperacute parenchymal hemorrhage of the brain. AJNR Am J Neuroradiol. 1998;19:1471\u20131477.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_12_2","unstructured":"Deleted in proof."},{"key":"e_1_3_2_13_2","unstructured":"Fullerton GD. Physiologic basis of magnetic relaxation. In: Stark DD Bradley WG eds. Magnetic Resonance Imaging. 2nd ed. St Louis Mo: Mosby Year Book; 1992:88\u2013108."}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.30.11.2263","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T08:32:04Z","timestamp":1738830724000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.30.11.2263"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,11]]},"references-count":13,"journal-issue":{"issue":"11","published-print":{"date-parts":[[1999,11]]}},"alternative-id":["10.1161\/01.STR.30.11.2263"],"URL":"https:\/\/doi.org\/10.1161\/01.str.30.11.2263","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,11]]},"assertion":[{"value":"1999-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-07-26","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-07-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-11-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}