CT angiography spot sign predicts hematoma expansion in acute intracerebral hemorrhage

Morbidity and mortality in spontaneous intracerebral hemorrhage (ICH) are correlated with hematoma progression. We hypothesized that the presence of tiny, enhancing foci ("spot sign") within acute hematomas is associated with hematoma expansion. We prospectively studied 39 consecutive pati...

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Bibliographic Details
Published in:Stroke (1970) 2007-04, Vol.38 (4), p.1257-1262
Main Authors: WADA, Ryan, AVIV, Richard I, FOX, Allan J, SAHLAS, Demetrios J, GLADSTONE, David J, TOMLINSON, George, SYMONS, Sean P
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Brain - diagnostic imaging
Brain - pathology
Brain - physiopathology
Cardiovascular system
Cerebral Angiography - methods
Cerebral Angiography - statistics & numerical data
Cerebral Arteries - diagnostic imaging
Cerebral Arteries - pathology
Cerebral Arteries - physiopathology
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - pathology
Cerebral Hemorrhage - physiopathology
Disease Progression
Female
Hematoma - diagnostic imaging
Hematoma - pathology
Hematoma - physiopathology
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Multivariate Analysis
Nervous system
Neurology
Observer Variation
Predictive Value of Tests
Prognosis
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Tomography, X-Ray Computed - methods
Tomography, X-Ray Computed - statistics & numerical data
Vascular diseases and vascular malformations of the nervous system
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Summary:Morbidity and mortality in spontaneous intracerebral hemorrhage (ICH) are correlated with hematoma progression. We hypothesized that the presence of tiny, enhancing foci ("spot sign") within acute hematomas is associated with hematoma expansion. We prospectively studied 39 consecutive patients with spontaneous ICH by computed tomography angiography within 3 hours of symptom onset. Scans were reviewed by 3 readers. Patients were dichotomized according to the presence or absence of the spot sign. Clinical and radiological outcomes were compared between groups. The predictive value of this sign was assessed in a multivariate analysis. Thirteen patients (33%) demonstrated 31 enhancing foci. Baseline clinical variables were similar in both groups. Hematoma expansion occurred in 11 patients (28%) on follow-up. Seventy-seven percent of patients with and 4% without hematoma expansion demonstrated the spot sign (P
ISSN:0039-2499
1524-4628
DOI:10.1161/01.STR.0000259633.59404.f3