Priorities for Clinical Research in Intracerebral Hemorrhage Stroke Volume 36(3):E23-E41 March 1, 2005 Copyright © American Heart Association, Inc. All rights reserved.

Figure 1. Magnetic susceptibility effects at 7T magnetic field strength. Figure 1. Magnetic susceptibility effects at 7T magnetic field strength. Sagittal T2-weighted image of the brain at 7T showing highly visible vessels because of magnetic susceptibility effects that highlight the presence of hemoglobin. High-resolution and high-field-strength MRI may be particularly well suited for evaluating both acute and chronic hemorrhage because of the presence of iron. (Image courtesy of Lawrence Wald, PhD, Massachusetts General Hospital, HST AA Martinos Center.)‏ NINDS ICH Workshop Participants Stroke. 2005;36:E23-E41 Copyright © American Heart Association, Inc. All rights reserved.

Figure 2. Perihematoma hypoperfusion demonstrated by xenon-enhanced CT scan. Figure 2. Perihematoma hypoperfusion demonstrated by xenon-enhanced CT scan. Imaging was performed 4 hours after the onset of right hemiparesis and aphasia in a 54-year old woman with history of hypertension. The xenon/CT cerebral blood flow images were obtained 1 cm above the level of the hematoma, initially at a blood pressure of 175/ 100 mm Hg and again 20 minutes later at a pressure of 140/80 mm Hg after intravenous treatment with labetalol. The lower blood pressure appears to result in more extensive tissue hypoperfusion. The lower images are windowed to show pixels with flow values below 20 cc/100gms/min in blue and pixels with values below 8 cc/100gms/min in lavender. NINDS ICH Workshop Participants Stroke. 2005;36:E23-E41 Copyright © American Heart Association, Inc. All rights reserved.

Figure 3. Diffusion tensor tractography demonstrating severe asymmetry after hemorrhagic stroke. Figure 3. Diffusion tensor tractography demonstrating severe asymmetry after hemorrhagic stroke. Inset shows a T2-weighted image five months after ictus demonstrating residual hemorrhage in the posterior right basal ganglia. Tractography using symmetrical seed-points in the brainstem demonstrates marked reduction of fiber tracts in the affected (right) hemisphere compared to the left. Directional color scheme: red indicates right-left; green, anterior-posterior; blue, superior-inferior. Diffusion tractography may be able to identify white matter tracts and changes in them related to ICH and recovery. (Image courtesy of A. Gregory Sorensen, MD, Massachusetts General Hospital, HST AA Martinos Center.)‏ NINDS ICH Workshop Participants Stroke. 2005;36:E23-E41 Copyright © American Heart Association, Inc. All rights reserved.