Research Article| Volume 425, 117434, June 15, 2021

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Timing of diffusion weighted imaging lesions in spontaneous intracerebral hemorrhage

Published:April 03, 2021DOI:


      • 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.



      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.


      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.


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