Computed tomography in spontaneous intracerebral haematomas

Abstract

The typical computed tomographic (CT) features of a recent [human] intracerebral hematoma are a homogenous region of increased attenuation, surrounded by a well demarcated, relatively narrow low attenuation ring (LAR). The pathology of the LAR is controversial, but it corresponds well with a zone of ischemic necrosis which is observed around most intracerebral hematomas examined at autopsy. Observations are made on spontaneous intracerebral hematomas and on blood samples which confirm that extravasated blood clot undergoes a variable degree of retraction which is completed within 6 h. This suggests that the LAR in recent hematoma is due to damage caused by the greater volume of the precontracted hemorrhage on the surrounding brain. CT abnormalities in intracerebral hematomas were studied; features which were useful in distinguishing spontaneous hematomas and those which affected prognosis are discussed.