Imaging

Intracerebral hemorrhage

Preliminary Diagnosis: Intracerebral Hemorrhage

I. What imaging technique is first-line for this diagnosis

  • Noncontrast CT of the brain

II. Describe the advantages and disadvantages of this technique for diagnosis of an intracerebral hemorrhage.

Advantages

  • Relatively inexpensive and more efficient and faster imaging modality compared to MR imaging

  • Very specific and sensitive in evaluating for intracerebral hemorrhage

  • Great at evaluating for any associated osseous abnormality

Disadvantages

  • Exposes patients to ionizing radiation

III. What are the contraindications for the first-line imaging technique?

  • Contraindicated in pregnant patients

IV. What alternative imaging techniques are available?

  • MR imaging according to trauma/hemorrhage protocol

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of an intracerebral hemorrhage.

MR imaging according to trauma/hemorrhage protocol

Advantages

  • More sensitive and specific for detecting subtle petechial intra axial hemorrhages and extra -axial hemorrhages of all varieties and sizes than CT

Disadvantages

  • Expensive

  • Time consuming

  • Requires significant patient cooperation to minimize artifact

VI. What are the contraindications for the alternative imaging techniques?

MR imaging according to Trauma/Hemorrhage protocol

  • Contraindicated in patients with non MR compatible hardware.

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