Clinical neuroimaging in intracerebral haemorrhage related to cerebral small vessel disease: contemporary practice and emerging concepts.

Göldlin, Martina; Stewart, Catriona; Radojewski, Piotr; Wiest, Roland; Seiffge, David; Werring, David J (2022). Clinical neuroimaging in intracerebral haemorrhage related to cerebral small vessel disease: contemporary practice and emerging concepts. Expert review of neurotherapeutics, 22(7), pp. 579-594. Taylor & Francis 10.1080/14737175.2022.2104157

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About 80% of all non-traumatic intracerebral haemorrhage (ICH) are caused by the sporadic cerebral small vessel diseases deep perforator arteriopathy (DPA, also termed hypertensive arteriopathy or arteriolosclerosis) and cerebral amyloid angiopathy (CAA), though these frequently co-exist in older people. Contemporary neuroimaging (MRI and CT) detects an increasing spectrum of haemorrhagic and non-haemorrhagic imaging biomarkers of small vessel disease which may identify the underlying arteriopathies.


We discuss biomarkers for cerebral small vessel disease subtypes in ICH, and explore their implications for clinical practice and research.


ICH is not a single disease, but results from a defined range of vascular pathologies with important implications for prognosis and treatment. The terms "primary" and "hypertensive" ICH are poorly defined and should be avoided, as they encourage incomplete investigation and classification. Imaging-based criteria for CAA will show improved diagnostic accuracy, but specific imaging biomarkers of DPA are needed. Ultra-high-field 7T-MRI using structural and quantitative MRI may provide further insights into mechanisms and pathophysiology of small vessel disease. We expect neuroimaging biomarkers and classifications to allow personalized treatments (e.g. antithrombotic drugs) in clinical practice and to improve patient selection and monitoring in trials of targeted therapies directed at the underlying arteriopathies.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Göldlin, Martina Béatrice, Radojewski, Piotr, Wiest, Roland Gerhard Rudi, Seiffge, David Julian


600 Technology > 610 Medicine & health




Taylor & Francis




Pubmed Import

Date Deposited:

20 Jul 2022 10:09

Last Modified:

02 Mar 2023 23:36

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

CT Intracerebral hemorrhage MRI amyloid-related inflammation cerebral amyloid angiopathy deep perforator arteriopathy emerging strategies hereditary small vessel disease neuroimaging small vessel diseases


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