Cerebral microhemorrhage

Hypertensive
microangiopathy • Hypertensive encephalopathy and hypertrophic olivary degeneration - Ganzer Fall bei Radiopaedia
Gaillard, F. Hypertensive encephalopathy and hypertrophic olivary degeneration. Case study, Radiopaedia.org. (accessed on 22 Oct 2022) https://doi.org/10.53347/rID-49190 • CC by-nc-sa 3.0 (modified)
Comparison of
conventional gradient echo T2*-weighted image (left, TE=20ms), susceptibility weighted image (SWI) and SWI phase image (center and right, respectively, TE=40ms) at 1.5 Tesla. Low signal foci in cerebral amyloid angiopathy (CAA) is shown.
Wikipedia • CC BY-SA 3.0
Cerebral
microhemorrhage • Immune effector cell-associated neurotoxicity syndrome (ICANS) - Ganzer Fall bei Radiopaedia
Gaillard F, Immune effector cell-associated neurotoxicity syndrome (ICANS). Case study, Radiopaedia.org (Accessed on 30 Oct 2023) https://doi.org/10.53347/rID-163107 • CC by-nc-sa 3.0 (modified)
Zahlreiche
zerebrale Mikroblutungen vorwiegend Thalamus und Basalganglien am ehesten als folge einer zerebrale hypertensiven Angiopathie. Oben T2, T1, unten FLAIR, SWI. Die Befunde sind mit Abstand am besten in der suszeptibilitätsgewichteten Sequenz sichtbar.
Wikipedia • CC BY-SA 4.0
Susceptibility
weighted image (SWI) of diffuse axonal injury in trauma at 1.5 Tesla. Conventional GRE (left) with TE=20 ms and SWI (right) with TE=20 ms.
Wikipedia • CC BY-SA 3.0
Microbleeds
show a characteristic distribution in cerebral fat embolism. A case showing microhemorrhages as seen on CT. Axial native CT scan images at the level of the centrum semiovale and the basal ganglia of a 16-year-old polytraumatised female patient acquired on postoperative day 11 after hospital admission. Multiple subcortical punctiform hyperdensities presumably representing microhemorrhages are seen bilaterally in the subcortical white matter (a), and a larger hyperdensity is seen in the genu of the corpus callosum (b)
insightsimaging.springeropen.com • CC-by-4.0
Microbleeds
show a characteristic distribution in cerebral fat embolism. A case representing the walnut kernel microbleed pattern. SWI (a–d) MRI images at the level of the centrum semiovale (a), at the level of the corona radiata (b), at the level of the basal ganglia (c), and at the level of the brainstem and the cerebellum (d) of a 16-year-old polytraumatised female patient acquired on day 12 after hospital admission. SWI shows very high number of monotonous punctuate microbleeds in the subcortical white matter, the internal capsule, the corpus callosum, the cerebellum and the brainstem resembling a “walnut kernel”. The larger hypointensity visible in the right centrum semiovale and near the third ventricle is due to a ventricular drain (a–c)
insightsimaging.springeropen.com • CC-by-4.0
Cerebral
microhemorrhage • Parry-Romberg syndrome with intracranial manifestations - Ganzer Fall bei Radiopaedia
Saad, A. Parry-Romberg syndrome with intracranial manifestations. Case study, Radiopaedia.org. (accessed on 22 Oct 2022) https://doi.org/10.53347/rID-50949 • CC by-nc-sa 3.0 (modified)
Cerebral
microhemorrhage • Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) - Ganzer Fall bei Radiopaedia
Hanh, L. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Case study, Radiopaedia.org. (accessed on 22 Oct 2022) https://doi.org/10.53347/rID-95083 • CC by-nc-sa 3.0 (modified)
Diffuses
axonales Schertrauma bei Motorradunfall. Kontrolle in der MRT nach 3 Tagen: Man erkennt die aus der CCT bekannte kleine balkennahe Blutung in der T1w schon nicht mehr. Gut zu sehen allerdings in FLAIR, DWI und am besten in der T2* (Haem).
Wikipedia • CC BY-SA 3.0
Cerebral
microhemorrhage • COVID-19 complicated by leukoencephalopathy and cerebral microhemorrhages - Ganzer Fall bei Radiopaedia
Elswood, T. COVID-19 complicated by leukoencephalopathy and cerebral microhemorrhages. Case study, Radiopaedia.org. (accessed on 22 Oct 2022) https://doi.org/10.53347/rID-94888 • CC by-nc-sa 3.0 (modified)
Cerebral
microhemorrhage • Posterior reversible encephalopathy syndrome with microhemorrhage (importance of susceptibility-weighted imaging) - Ganzer Fall bei Radiopaedia
Ibrahim, D. Posterior reversible encephalopathy syndrome with microhemorrhage (importance of susceptibility-weighted imaging). Case study, Radiopaedia.org. (accessed on 22 Oct 2022) https://doi.org/10.53347/rID-87081 • CC by-nc-sa 3.0 (modified)
Central
nervous system vasculitis • Granulomatous vasculitis - Ganzer Fall bei Radiopaedia
S R, Granulomatous vasculitis. Case study, Radiopaedia.org (Accessed on 08 Dec 2022) https://doi.org/10.53347/rID-98233 • CC by-nc-sa 3.0 (modified)
Radiopaedia • CC-by-nc-sa 3.0 • de

Cerebral microhemorrhages, or cerebral microbleeds, are small focal intracerebral hemorrhages, often only visible on susceptibility-sensitive MRI sequences.

Pathology

Common etiologies
Less common etiologies

Radiographic features

Cerebral microhemorrhages are generally only seen on MRI and are best seen on susceptibility weighted T2* sequences such as gradient-recalled echo (GRE) and susceptibility weighted imaging (SWI).

They appear as conspicuous 2-10 millimeter punctate regions of signal drop out with blooming artifact. This blooming grossly overestimates the size of the lesions, and they are usually inapparent on other sequences.

Differential diagnosis

  • artificial heart valve metallic emboli (very rare)
  • pneumocephalus (very rare without proceeding surgery)
  • flow voids of veins
  • intracranial calcification
Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu zerebrale Mikroblutungen:
Pneumocephalus
 
Wikipedia • CC BY-SA 3.0
Diffuses
axonales Schädelhirntrauma
Wikipedia • CC BY-SA 3.0
zerebrale
Kavernome
Wikipedia • CC BY-SA 4.0
Mikroblutungen
in den Basalganglien
www.eurorad.org • CC by-nc-sa-4.0