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2018, Number 2

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Rev Cubana Neurol Neurocir 2018; 8 (2)

Primary intraparenchymal cerebral hemorrhage neuroimaging

Hernández CA, Rodríguez GD

Language: Spanish
References: 40
Page: 1-21
PDF size: 743.60 Kb.


ABSTRACT

Objective: To describe current approaches for neuroimaging diagnosis of primary intraparenchymatous cerebral hemorrhage.
Evidence acquisition: Bibliographic references in English or Spanish were identified in PubMed for the last five years. The terms "Cerebral hemorrhage AND Diagnosis" or "Cerebral hematoma AND Diagnosis" were used. These investigations together with some classic references on the subject were consulted.
Results: Despite the usefulness of certain clinical variables, patients with a new stroke require immediate and obligatory cranial computerized tomography scan for the positive diagnosis. Volumetry of the hematoma is required by the ABC/2 method or its variants, and in the first eight hours of stroke, the combination with the computerized axial tomography angiography is necessary for the vascular etiological diagnosis. Another control study is suggested, after 24 hours, in symptomatic patients to determine the hematoma size and degree of expansion. The cerebral vessels image should be considered when vascular malformation is suspected, such as aneurysm or arteriovenous malformation. Venography is indicated when the hemorrhage location, the relative cerebral edema volume or abnormal signal in the cerebral sinuses in the neuroimaging suggest a cerebral venous thrombosis. When there is suspicion of underlying malformative or tumoral vascular injury, a multimodal neuroimaging control should be indicated at 2-6 weeks.
Conclusions: This paper described current neuroimaging strategies that allow the diagnosis and treatment of the patients with primary intraparenchymal cerebral hemorrhage, as well as the key guidelines to research on the subject.


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