Contrast leakage distant from the hematoma in patients with spontaneous ICH: A 7 T MRI study

Wilmar MT Jolink, Arjen Lindenholz, Ellis S van Etten, Koen M van Nieuwenhuizen, Floris Hbm Schreuder, Hugo J Kuijf, Matthias Jp van Osch, Jeroen Hendrikse, Gabriel Je Rinkel, Marieke JH Wermer, Catharina JM Klijn

Research output: Contribution to journalArticleAcademicpeer-review


Disruption of the blood-brain barrier (BBB) might play a role in the pathophysiology of cerebral small vessel disease-related ICH. The aim of this study was to assess presence and extent of contrast agent leakage distant from the hematoma as a marker of BBB disruption in patients with spontaneous ICH. We prospectively performed 7 tesla MRI in adult patients with spontaneous ICH and assessed contrast leakage distant from the hematoma on 3D FLAIR images. Thirty-one patients were included (mean age 60 years, 29% women). Median time between ICH and MRI was 20 days (IQR 9-67 days). Seventeen patients (54%; seven lobar, nine deep, one infratentorial ICH) had contrast leakage, located cortical in 16 and cortical and deep in one patient. Patients with contrast leakage more often had lobar cerebral microbleeds (CMBs; 77%) than those without (36%; RR 2.5, 95% CI 1.1-5.7) and a higher number of lobar CMBs (patients with contrast leakage: median 2, IQR 1-8 versus those without: median 0, IQR 0-2; p = 0.02). This study shows that contrast leakage distant from the hematoma is common in days to weeks after spontaneous ICH. It is located predominantly cortical and related to lobar CMBs and therefore possibly to cerebral amyloid angiopathy.

Original languageEnglish
Pages (from-to)1002-1011
Number of pages10
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number5
Publication statusPublished - 1 May 2020


  • Blood–brain barrier
  • cerebral microbleeds
  • intracerebral hemorrhage
  • magnetic resonance imaging
  • small vessel disease
  • Blood-brain barrier


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