Highlights
- •Half of DWI lesions in acute intracerebral hemorrhage occur in the first 7 days.
- •Most occur between 2 and 4 days after hospitalization.
- •Timing of DWI lesions has implications in elucidating a pathophysiologic mechanism.
Abstract
Introduction
Diffusion weighted imaging (DWI) lesions are common after spontaneous intracerebral
hemorrhage (sICH). However, their timing relative to a patient's admission to the
hospital is unknown. The purpose of this study is to estimate the timing of new DWI
lesions after admission for acute sICH.
Material and methods
Select patients enrolled in a single center prospective study examining the prevalence
DWI lesions in acute primary sICH received two MRI scans of the brain after admission.
The presence of a new DWI lesion between MRI scans was defined as a new DWI event.
A lognormal parametric model was used to estimate the median time (50% percentile)
to develop a new DWI lesion.
Results
Among the 121 participants enrolled in the study, 63 (52%) had two brain MRIs. The
median time from admission to 1st MRI was 1 day (IQR 1.2, range 0.1–8.4). The median
time between the 2 MRI scans was 2.1 (IQR 2.9, range 0.02–17.4) days. 30.2% (n = 19)
of participants developed a new DWI lesion between MRI scans. The estimated median
time from 1st MRI to new DWI event was 6.3 days (95% CI, 4.1 to 9.6).
Discussion and conclusion
Accounting for time from admission to 1st MRI, we found that 50% of new DWI lesions
occurred by 7.3 days after sICH admission. Pathophysiologic changes in sICH during
this time frame need to be studied in order to elucidate a mechanism for DWI lesions.
Keywords
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Article info
Publication history
Published online: April 03, 2021
Accepted:
April 1,
2021
Received in revised form:
March 9,
2021
Received:
November 23,
2020
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
