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Abstract Details

MRI Detection of Cerebral Infarction in Subarachnoid Hemorrhage
Cerebrovascular Disease and Interventional Neurology
S12 - (-)
003
CI is a well-known complication of SAH that is typically detected on CT. MRI has improved sensitivity for acute CI over CT (particularly with small asymptomatic lesions).
With IRB approval, we retrospectively reviewed consecutive SAH patients admitted to our institution between August 2006 to March 2011. Traumatic SAH were excluded. Data was collected on demographics, cause of SAH, Fisher Grade, and neuroimaging results. MRIs were reviewed by study authors to categorize pattern of CI as Single Cortical (SC), Single Deep (SD), Multiple Cortical (MC), Multiple Deep (MD), and Multiple Cortical and Deep (MCD).
Among 400 SAH patients, the mean age was 56.9 years (range 21 to 96). Fisher Grade was 2 in 17.5%, 3 in 75%, and 4 in 7.5%. The most common causes of SAH was aneurysmal in 292 (73%) and angiogram negative in 65 (16%). When using CT modality only, CI was detected in 101 patients (25%). When MRI was included, this increased detection of CI to 141 patients (35%). Among the cohort, 123 (30.8%) had MRIs during their hospitalization and approximately half of these MRIs (64) demonstrated acute CI. Most of the MRI visible lesions (61%) were not detectable on CT. The mean time from admission to MRI was 5.7 days (range 0 to 29 days). Among the 64 patients with MRI infarcts, the CI pattern included MC in 20 (31%), MCD in 18 (28%), SC in 16 (25%), SD in 5 (8%), and 5 (8%) had unavailable images.
The use of MRI can increase the detection of CI after SAH. MRI-detected CI after SAH tends to involve multiple vascular territories. Studies that rely on CT may underestimate the burden of CI after SAH.
Authors/Disclosures
Georgia Korbakis, MD
PRESENTER 		No disclosure on file
Shyam Prabhakaran, MD (University of Chicago) Dr. Prabhakaran has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Cincinnati. Dr. Prabhakaran has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Cincinnati. The institution of Dr. Prabhakaran has received research support from NIH . The institution of Dr. Prabhakaran has received research support from AHRQ. Dr. Prabhakaran has received publishing royalties from a publication relating to health care.
Sayona John, MD, FAAN (Rush University Medical Center) Dr. John has nothing to disclose.
Rajeev Garg, MD, FAAN (Rush University Medical Center) No disclosure on file
James Conners, MD (Rush University Medical Center) The institution of Dr. Conners has received research support from nih.
Richard E. Temes, MD (Northwell Health) No disclosure on file
Thomas P. Bleck, MD, FAAN (Northwestern University Department of Neurology) Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Marinus Pharmaceuticals. Dr. Bleck has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for iECURE. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acasti. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Society of Critical Care Medicine. Dr. Bleck has received research support from NIH.
Vivien H. Lee, MD, FAAN (OSU Comprehensive Neurovascular Center) Dr. Lee has nothing to disclose.
Emmanuelle Waubant, MD, PhD, FAAN (USCF MS Center) The institution of Dr. Waubant has received research support from NIH. The institution of Dr. Waubant has received research support from NMSS. The institution of Dr. Waubant has received research support from PCORI. The institution of Dr. Waubant has received research support from Race to Erase MS. The institution of Dr. Waubant has received research support from Roche. The institution of Dr. Waubant has received research support from Department of Defense. Dr. Waubant has received publishing royalties from a publication relating to health care.