Spot The New Lesion: A Case Report of Intra-MRI Cerebral Hemorrhage with Discussion of Previous Literature

The appearance of intracranial hemorrhage on Magnetic Resonance Imaging (MRI) is complex and depends on its evolution over time. The ability of the MRI to detect hyperacute hemorrhage has been debated as it seems to depend on several factors (ie. delay of imaging, MRI field strength, imaging technique). We present the first case of intracranial hemorrhage occurring during MRI acquisition in a 61-year-old female suffering a severe hypoxic-ischemic encephalopathy from a suicide attempt by hanging. The imaging characteristics of the hematoma differ from what has been described in the past as it lacks the typical peripheral T2 and T2* hypointensity usually seen in hyperacute hematomas. We discuss previous literature in order to explain these peculiar imaging features.