Small intracerebral hemorrhages have a low spot sign prevalence and are less likely to expand

International Journal of Stroke : Official Journal of the International Stroke Society
Dar DowlatshahiPREDICT/Sunnybrook ICH CTA Study Group

Abstract

Hematoma expansion is a major predictor of morbidity and mortality after intracerebral hemorrhage (ICH). Both baseline hematoma volume and the CT-angiogram (CTA) spot sign predict hematoma expansion. Because the CTA spot sign may represent foci of active hemorrhage, we hypothesized that patients with smaller baseline hematoma volumes are less likely to be spot sign positive, and therefore less likely to expand. We sought to validate our prior finding that small hematomas are unlikely to expand, and to determine the relationship between baseline hematoma volume, spot sign status, and risk of hematoma expansion. Data were from the prospective PREDICT ICH study. Patients presenting within 6 h of symptom onset with completed baseline CT, CTA, and follow-up CT were included. Baseline hematoma volume was categorized a priori (<3 mL, 3-10 mL, 10-20 mL, >20 mL). The primary outcome was significant hematoma expansion (≥6 mL, ≥12.5 mL or ≥33%) and secondary outcomes were early neurological worsening, good clinical outcome (modified Rankin Scale 0-3), and mortality at 90 days. Among 315 patients meeting the inclusion criteria, baseline hematoma volume category predicted absolute hematoma expansion (p < 0.001), spot sign prevalence (p < 0....Continue Reading

References

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Feb 25, 2011·Neurology·D DowlatshahiUNKNOWN VISTA Collaboration
May 12, 2011·International Journal of Stroke : Official Journal of the International Stroke Society·Dar DowlatshahiUNKNOWN VISTA Collaborators
May 26, 2011·International Journal of Stroke : Official Journal of the International Stroke Society·Jayme C KosiorUNKNOWN PREDICT/Sunnybrook CTA ICH study investigators
May 17, 2012·Stroke; a Journal of Cerebral Circulation·Dar DowlatshahiUNKNOWN PREDICT/Sunnybrook ICH-CTA study group
Jul 19, 2013·Cerebrovascular Diseases·Timolaos RizosThorsten Steiner
Nov 2, 2013·Stroke; a Journal of Cerebral Circulation·Dar DowlatshahiUNKNOWN Ottawa Stroke Research Group
Dec 25, 2013·JAMA Neurology·H Bart BrouwersJoshua N Goldstein

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Citations

Jan 6, 2018·Critical Care Medicine·Vignan YogendrakumarUNKNOWN Prediction of haematoma growth and outcome in patients with intracerebral haemorrhage using the CT-angiography spot sign [PR
Apr 12, 2019·Journal of the American Heart Association·Qi LiPeng Xie
Jun 4, 2017·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Zhiyuan YuChao You
Sep 1, 2017·European Stroke Journal·Vignan YogendrakumarDar Dowlatshahi
May 13, 2017·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Jun ZhengChao You
May 28, 2019·Neurocritical Care·Vignan YogendrakumarUNKNOWN PREDICT/Sunnybrook CTA Study Group
Mar 7, 2020·Annals of Clinical and Translational Neurology·Jochen A SembillHagen B Huttner
Dec 18, 2020·The British Journal of Radiology·Chenyi ZhanYunjun Yang
Mar 16, 2017·Stroke; a Journal of Cerebral Circulation·Gregoire BoulouisJoshua N Goldstein

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