Download the full-sized PDF of Ischemic Signatures in Acute Intracerebral HemorrhageDownload the full-sized PDF



Permanent link (DOI):


Export to: EndNote  |  Zotero  |  Mendeley


This file is in the following communities:

Graduate Studies and Research, Faculty of


This file is in the following collections:

Theses and Dissertations

Ischemic Signatures in Acute Intracerebral Hemorrhage Open Access


Other title
Diffusion-weighted MRI
Intracerebral Hemorrhage
Type of item
Degree grantor
University of Alberta
Author or creator
Gioia, Laura C.
Supervisor and department
Butcher, Ken (Medicine)
Examining committee member and department
Jeerakathil, Thomas (medicine)
Jickling, Glen (medicine)
Wilman, Alan
Beaulieu, Christian (Biomedical Engineering)
Department of Medicine
Translational Medicine
Date accepted
Graduation date
2017-06:Spring 2017
Master of Science
Degree level
Introduction: Acute blood pressure (BP) reduction is among the few treatments options available in the acute management of intracerebral hemorrhage (ICH). Recent observational studies have demonstrated the presence of lesions suggestive of ischemia on diffusion-weighted sequences (DWI) on MRI. We hypothesized that DWI lesions in ICH are independent from acute BP reduction and hypoperfusion. Methods: Patients with spontaneous ICH undergoing MR imaging were retrospectively enrolled in the first part of the study. In the second part of the study, ICH patients who underwent MRI with perfusion-weighted imaging were prospectively enrolled. Perilesional cerebral blood flow (CBF) was calculated on post-processed calibrated perfusion maps. Results: One hundred-seventeen patients were enrolled in the first substudy. DWI lesions in regions remote to the hematoma were found in 17 (14.7%) patients. Maximal SBP drop at 24 hours was similar in patients with (-20.5(51) mmHg) and without remote DWI lesions (-27(33.5) mmHg, p=0.96). Nineteen patients were enrolled in the second substudy. On baseline MRI, 3 DWI hyperintensities remote to the hematoma were found in 2 patients and 1 subsequent remote DWI hyperintensity was found in one patient on day 7 MRI. Mean absolute perilesional CBF was 37.6 ± 17.2 ml/100g/min with a perilesional rCBF of 1.1 ± 0.1. Mean absolute internal borderzone (BZ) CBF was slightly lower in patients with DWI lesions (18.8 ± 1.8 ml/100g per minute) than patients without DWI lesions (22.6 ± 8.0 ml/100g, p=0.29); however, mean rCBF in the internal BZ regions did not differ between groups (0.96 ± 0.01 and 1.0 ± 0.2, respectively, p=0.37). Conclusion: DWI lesions remote to the hematoma region are commonly observed in sponatneous ICH. Remote DWI lesions are not associated with acute 24-hour BP reduction nor do they appear to be associated with perilesional or borderzone hypoperfusion. These data do not support a hemodynamic mechanism of ischemic injury after spontaneous ICH.  
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
Citation for previous publication
L.C. Gioia, M.P. Kate, D. Dowlatshahi, M.D. Hill, and K. Butcher, “Blood Pressure Management In Acute Intracerebral Hemorrhage: Current Evidence And Ongoing Controversies,” Current Opinion of Critical Care, 2015, vol. 21, issue 2, page 99-106,L.C. Gioia, M.P. Kate, V Choi, L Sivakumar, T Jeerakathil, J Kosior, D Emery, and K. Butcher, “Ischemia in intracerebral hemorrhage is associated with leukoaraiosis and hematoma volume, not blood pressure reduction,” Stroke, 2015, vol. 46, issue 6, page 1541-7,

File Details

Date Uploaded
Date Modified
Audit Status
Audits have not yet been run on this file.
File format: pdf (PDF/A)
Mime type: application/pdf
File size: 2338862
Last modified: 2017:06:13 12:27:43-06:00
Filename: Gioia_Laura_C_201703_MSc.pdf
Original checksum: abf45650fd9c1cbea89fe7f8e990a91b
Activity of users you follow
User Activity Date