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Analysis of the utility of early MRI/MRA in 400 patients with spontaneous intracerebral hemorrhage.

Publication ,  Journal Article
Chalouhi, N; Mouchtouris, N; Al Saiegh, F; Das, S; Sweid, A; Flanders, AE; Starke, RM; Baldassari, MP; Tjoumakaris, S; Gooch, MR; Shah, SO ...
Published in: J Neurosurg
May 31, 2019

OBJECTIVE: MRI and MRA studies are routinely obtained to identify the etiology of intracerebral hemorrhage (ICH). The diagnostic yield of MRI/MRA in the setting of an acute ICH, however, remains unclear. The authors' goal was to determine the utility of early MRI/MRA in detecting underlying structural lesions in ICH and to identify patients in whom additional imaging during hospitalization could safely be foregone. METHODS: The authors reviewed data obtained in 400 patients with spontaneous ICH diagnosed on noncontrast head CT scans who underwent MRI/MRA between 2015 and 2017 at their institution. MRI/MRA studies were reviewed to identify underlying lesions, such as arteriovenous malformations, aneurysms, cavernous malformations, arteriovenous fistulas, tumors, sinus thrombosis, moyamoya disease, and abscesses. RESULTS: The median patient age was 65 ± 15.8 years. Hypertension was the most common (72%) comorbidity. Structural abnormalities were detected on MRI/MRA in 12.5% of patients. Structural lesions were seen in 5.7% of patients with basal ganglia/thalamic ICH, 14.1% of those with lobar ICH, 20.4% of those with cerebellar ICH, and 27.8% of those with brainstem ICH. Notably, the diagnostic yield of MRI/MRA was 0% in patients > 65 years with a basal ganglia/thalamic hemorrhage and 0% in those > 85 years with any ICH location, whereas it was 37% in patients < 50 years and 23% in those < 65 years. Multivariate analysis showed that decreasing age, absence of hypertension, and non-basal ganglia/thalamic location were predictors of finding an underlying lesion. CONCLUSIONS: The yield of MRI/MRA in ICH is highly variable, depending on patient age and hemorrhage location. The findings of this study do not support obtaining early MRI/MRA studies in patients ≥ 65 years with basal ganglia/thalamic ICH or in any ICH patients ≥ 85 years. In all other situations, early MRI/MRA remains valuable in ruling out underlying lesions.

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Published In

J Neurosurg

DOI

EISSN

1933-0693

Publication Date

May 31, 2019

Volume

132

Issue

6

Start / End Page

1865 / 1871

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences
 

Citation

APA
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ICMJE
MLA
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Chalouhi, N., Mouchtouris, N., Al Saiegh, F., Das, S., Sweid, A., Flanders, A. E., … Jabbour, P. (2019). Analysis of the utility of early MRI/MRA in 400 patients with spontaneous intracerebral hemorrhage. J Neurosurg, 132(6), 1865–1871. https://doi.org/10.3171/2019.2.JNS183425
Chalouhi, Nohra, Nikolaos Mouchtouris, Fadi Al Saiegh, Somnath Das, Ahmad Sweid, Adam E. Flanders, Robert M. Starke, et al. “Analysis of the utility of early MRI/MRA in 400 patients with spontaneous intracerebral hemorrhage.J Neurosurg 132, no. 6 (May 31, 2019): 1865–71. https://doi.org/10.3171/2019.2.JNS183425.
Chalouhi N, Mouchtouris N, Al Saiegh F, Das S, Sweid A, Flanders AE, et al. Analysis of the utility of early MRI/MRA in 400 patients with spontaneous intracerebral hemorrhage. J Neurosurg. 2019 May 31;132(6):1865–71.
Chalouhi, Nohra, et al. “Analysis of the utility of early MRI/MRA in 400 patients with spontaneous intracerebral hemorrhage.J Neurosurg, vol. 132, no. 6, May 2019, pp. 1865–71. Pubmed, doi:10.3171/2019.2.JNS183425.
Chalouhi N, Mouchtouris N, Al Saiegh F, Das S, Sweid A, Flanders AE, Starke RM, Baldassari MP, Tjoumakaris S, Gooch MR, Shah SO, Hasan D, Herial N, D’Ambrosio R, Rosenwasser R, Jabbour P. Analysis of the utility of early MRI/MRA in 400 patients with spontaneous intracerebral hemorrhage. J Neurosurg. 2019 May 31;132(6):1865–1871.

Published In

J Neurosurg

DOI

EISSN

1933-0693

Publication Date

May 31, 2019

Volume

132

Issue

6

Start / End Page

1865 / 1871

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences