Parenchymal hemorrhage, late subacute

Hemorrhage-Mar-2013.jpg

Image 1

Clinical History: 
A 68 year-old woman several weeks following a stroke.

Diagnosis:
Parenchymal hemorrhage, late subacute

MR Technique: 
Axial 5 mm pre-contrast SE T1- and FSE T2-weighted images are presented, acquired at 1.5 T on a Siemens Avanto MR system. Sequence parameters were TR/TE = 481/10 and 5240/111, with scan times of 3:14 and 2:32, respectively.

Imaging Findings:
Two focal lesions, with abnormal high signal intensity on both T1- and T2-weighted scans, are noted, one within the putamen and one within the globus pallidus on the right. The signal intensity characteristics are compatible with extracellular methemoglobin. There is a subtle low signal intensity rim around each fluid collection on the T2-weighted scan, consistent with hemosiderin. Mild abnormal high signal intensity is noted adjacent to each lesion on the T2-weighted scan, consistent with vasogenic edema, denoting a slightly larger area of late subacute infarction (lentiform nucleus in distribution) within which these two areas of hemorrhage lie