MRI for the Early Evaluation of Acute Intracerebral Hemorrhage

Study Overview
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Brief Summary
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What happens in the borderzone of a cerebral hemorrhage remains widely onknown and furhter the best timing for doing MR to look for vascular pathology in cerebral hemorrhage has not yet been determined. In this study we do acute MRS, a non-invasive imaging mathod to detemine the biochemsty in the border zone and structural MRI for vascular malformation. We repeat structural MRI after 8 weeks.

Detailed Description
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In this study we want to investigate the ability of MRI to identify underlying pathology (tumor or vascular malformations) in acute patients admitted with intracerebral hemorrhage (ICH). Today MRI-scan is normally done 3-4 weeks after symptom onset but very little is known about the early use of MRI to detect underlying pathology. This would allow an early intervension and less uncertainty for the patients. We further want to investigate the metabolic penumbra-zone surrounding the hematoma. It is the current perception in the litterature that this zone represent a metabolic zone marked by apoptosis and inflammation rather than ischemia. We are planning to: When patients arrive in our stroke department they will within 7 hours be subject to MRI scan with the protocoled sequences. Standard sequences: Axial T2, axial DWI, Sagittal T1, T2 flair og axial GRE-sequence. Susceptibility weighted imaging (SWI) Chemical Shift Imaging (CSI) multivoxel spectroscopi Post contrast 3D box reconstruction After 8 weeks the patients are subject to another MRI-Scan in accordance with the standard clinical guideline to rule out underlying pathology. After 3 month the patients are seen in the outpatient-clinic to follow-up evaluation. To sum up the purpose of this present study is to conduct a pilot investigation of MRI in the early evaluation of ICH-patients. Second it is our intension to use multivoxel magnetic resonance spectroscopy to study the metabolic penumbra-zone surrounding the ICH.

Official Title
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MRI for Early Identification of Underlying Pathology in Patients With Acute Intracerebral Hemorrhage

Conditions
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Cerebral Hemorrhage, Intracranial Arteriovenous Malformations, Intracranial Hemorrhage, Hypertensive, Brain Neoplasms

Intervention / Treatment
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* Device: MRI Scan with the specified sequences below:


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: CT demonstrated ICH Cardiopulmonary stable Informed consent from patient or proxy No General contraindication of MRI Age above 18 Exclusion Criteria: Lack of informed consent lack of cooperability

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Intracerebral Hemorrhage Patients<br>Patients admitted with acute intracerebral hemorrhage within 72 hours after symptom onset.Patients are included in the study for MRI studies | Device: MRI Scan with the specified sequences below:<br>* Standard sequences: Axial T2, axial DWI, Sagittal T1, T2 flair og axial GRE-sequence. Susceptibility weighted imaging (SWI) Chemical Shift Imaging (CSI) multivoxel spectroscopi Post contrast 3D box reconstruction<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| early correct diagnosis of underlying vascular malformation | Correct diagnosis based on findings on 8 weeks control MRI | 8 weeks |