So Hyun Kim1, Hyun Ho Jung2, Kum Whang1, Jong Yun Kim1, Jin Su Pyen1, Ji Woong Oh1. 1. Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University, Wonju, Korea. 2. Department of Neurosurgery, Severance Hospital, Yonsei University, Seoul, Korea.
Abstract
OBJECTIVE: The spot sign is related with the risk of hematoma expansion in spontaneous intracerebral hemorrhage (ICH). However, not all spot sign positive patients undergo hematoma expansion. Thus, the present study investigates the specific factors enhancing the spot sign positivity in predicting hematoma expansion. METHODS: We retrospectively studied 316 consecutive patients who presented between March 2009 to March 2011 with primary ICH and whose initial computed tomography brain angiography (CTA) was performed at our Emergency Department. Of these patients, 47 primary ICH patients presented spot signs in their CTA. We classified these 47 patients into two groups based on the presence of hematoma expansion then analyzed them with the following factors : gender, age, initial systolic blood pressure, history of anti-platelet therapy, volume and location of hematoma, time interval from symptom onset to initial CTA, spot sign number, axial dimension, and Hounsfield Unit (HU) of spot signs. RESULTS: Of the 47 spot sign positive patients, hematoma expansion occurred in 26 patients (55.3%) while the remaining 21 (44.7%) showed no expansion. The time intervals from symptom onset to initial CTA were 2.42±1.24 hours and 3.69±2.57 hours for expansion and no expansion, respectively (p=0.031). The HU of spot signs were 192.12±45.97 and 151.10±25.14 for expansion and no expansion, respectively (p=0.001). CONCLUSIONS: The conditions of shorter time from symptom onset to initial CTA and higher HU of spot signs are the emphasizing factors for predicting hematoma expansion in spot sign positive patients.
OBJECTIVE: The spot sign is related with the risk of hematoma expansion in spontaneous intracerebral hemorrhage (ICH). However, not all spot sign positive patients undergo hematoma expansion. Thus, the present study investigates the specific factors enhancing the spot sign positivity in predicting hematoma expansion. METHODS: We retrospectively studied 316 consecutive patients who presented between March 2009 to March 2011 with primary ICH and whose initial computed tomography brain angiography (CTA) was performed at our Emergency Department. Of these patients, 47 primary ICHpatients presented spot signs in their CTA. We classified these 47 patients into two groups based on the presence of hematoma expansion then analyzed them with the following factors : gender, age, initial systolic blood pressure, history of anti-platelet therapy, volume and location of hematoma, time interval from symptom onset to initial CTA, spot sign number, axial dimension, and Hounsfield Unit (HU) of spot signs. RESULTS: Of the 47 spot sign positive patients, hematoma expansion occurred in 26 patients (55.3%) while the remaining 21 (44.7%) showed no expansion. The time intervals from symptom onset to initial CTA were 2.42±1.24 hours and 3.69±2.57 hours for expansion and no expansion, respectively (p=0.031). The HU of spot signs were 192.12±45.97 and 151.10±25.14 for expansion and no expansion, respectively (p=0.001). CONCLUSIONS: The conditions of shorter time from symptom onset to initial CTA and higher HU of spot signs are the emphasizing factors for predicting hematoma expansion in spot sign positive patients.
Authors: H Bart Brouwers; Guido J Falcone; Kristen A McNamara; Alison M Ayres; Alexandra Oleinik; Kristin Schwab; Javier M Romero; Anand Viswanathan; Steven M Greenberg; Jonathan Rosand; Joshua N Goldstein Journal: Neurocrit Care Date: 2012-12 Impact factor: 3.210
Authors: Hagen B Huttner; Peter D Schellinger; Marius Hartmann; Martin Köhrmann; Eric Juettler; Johannes Wikner; Stephan Mueller; Uta Meyding-Lamade; Ralf Strobl; Ulrich Mansmann; Stefan Schwab; Thorsten Steiner Journal: Stroke Date: 2006-05-04 Impact factor: 7.914
Authors: Joseph P Broderick; Michael N Diringer; Michael D Hill; Nikolai C Brun; Stephan A Mayer; Thorsten Steiner; Brett E Skolnick; Stephen M Davis Journal: Stroke Date: 2007-02-08 Impact factor: 7.914
Authors: Charlotte Jj van Asch; Merel Ja Luitse; Gabriël Je Rinkel; Ingeborg van der Tweel; Ale Algra; Catharina Jm Klijn Journal: Lancet Neurol Date: 2010-01-05 Impact factor: 44.182
Authors: Josser E Delgado Almandoz; Albert J Yoo; Michael J Stone; Pamela W Schaefer; Joshua N Goldstein; Jonathan Rosand; Alexandra Oleinik; Michael H Lev; R Gilberto Gonzalez; Javier M Romero Journal: Stroke Date: 2009-07-02 Impact factor: 7.914
Authors: Vignan Yogendrakumar; Andrew M Demchuk; Richard I Aviv; David Rodriguez-Luna; Carlos A Molina; Yolanda S Blas; Imanuel Dzialowski; Adam Kobayashi; Jean-Martin Boulanger; Cheemun Lum; Gord Gubitz; Vasantha Padma; Jayanta Roy; Carlos S Kase; Rohit Bhatia; Michael D Hill; Dar Dowlatshahi Journal: Eur Stroke J Date: 2017-06-15
Authors: Michaël T J Peeters; Kim J D de Kort; Rik Houben; Wouter J P Henneman; Robert J van Oostenbrugge; Julie Staals; Alida A Postma Journal: J Stroke Date: 2021-01-31 Impact factor: 6.967