MR OF CEREBRAL ABNORMALITIES CONCOMITANT WITH PRIMARY INTRACEREBRAL HEMATOMAS

PURPOSE: To determine whether arteriolar vessel wall degeneration in p rimary intracerebral hematomas might be associated with ischemic brain lesions and clinically silent (apparently intracerebral) previous hem orrhages. METHODS: The MR images of 120 consecutive patients (mean age , 60 years; age range, 22 to 84 years) with their first stroke caused by a primary intracerebral hematoma were reviewed retrospectively for coexisting ischemic damage and previous bleeds. RESULTS: Early conflue nt to confluent white matter hyperintensities, lacunes, or infarction were present in 83 (69%) of the patients, and 39 (33%) had had previou s hemorrhages consisting of microbleeds or old hematomas. Extensive wh ite matter hyperintensities and lacunes were most frequent in patients with thalamic primary intracerebral hematomas. There was no relations hip between the frequency of old hemorrhages and the location of subse quent primary intracerebral hematomas, CONCLUSION: Clinically silent i schemic lesions and previous hemorrhages are a common finding on MR im ages of patients with primary intracerebral hematoma, They may therefo re serve as evidence of diffuse microangiopathy with a possible increa sed risk for cerebral hemorrhage.