Abstract TP337: Multiphase CTA Improves ICH Expansion Prediction and Might Provide Additional Information on the Pathophysiology of the Spot Sign

• Published in: Stroke (1970) 2017-02, Vol.48 (suppl_1)
• Main Authors: Rodriguez-Luna, David, Coscojuela, Pilar, Rodriguez-Villatoro, Noelia, Juega, Jesus M, Boned, Sandra, Muchada, Marian, Pagola, Jorge, Rubiera, Marta, Ribo, Marc, Tomasello, Alejandro, Demchuk, Andrew M, Goyal, Mayank, Molina, Carlos A
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.48.suppl_1.tp337

Abstract only Background: Although the spot sign is a strong predictor of hematoma expansion, there is no accepted consensus on the timing of CTA acquisition, mainly because its pathophysiologic significance is uncertain. We investigated the yield of the spot sign in the prediction of hematoma expansion and its pathophysiological underpinnings using multiphase CTA. Methods: Single-center prospective observational cohort study of 123 consecutive patients with acute (33% or >6 mL, primary outcome), and absolute hematoma growth. Results: The frequency of the spot sign was higher the later the phase of CTA was: 29.3% in phase 1, 43.1% in 2, and 46.3% in 3 ( P C > D > no spot sign ( P =0.003, Figure). Conclusions: Multiphase CTA improves hematoma expansion prediction and might provide additional information on the pathophysiology of the spot sign. Arterial spot signs may represent the point of active hemorrhage, and venous spot signs the site of resolved bleeding.