Objective: The purpose of this study was to retrospectively review cases of intracerebral hemorrhage (ICH) medically treated at our institution to determine if the CT angiography (CTA) 'spot sign' predicts in-hospital mortality and clinical outcome at 3 months in patients with spontaneous ICH.
Methods: We conducted a retrospective review of all consecutive patients who were admitted to the department of neurosurgery. Clinical data of patients with ICH were collected by 2 neurosurgeons blinded to the radiological data and at the 90-day follow-up.
Results: Multivariate logistic regression analysis identified predictors of poor outcome; we found that hematoma location, spot sign, and intraventricular hemorrhage were independent predictors of poor outcome. In-hospital mortality was 57.4% (35 of 61) in the CTA spot-sign positive group versus 7.9% (10 of 126) in the CTA spot-sign negative group. In multivariate logistic analysis, we found that presence of spot sign and presence of volume expansion were independent predictors for the in-hospital mortality of ICH.
Conclusion: The spot sign is a strong independent predictor of hematoma expansion, mortality, and poor clinical outcome in primary ICH. In this study, we emphasized the importance of hematoma expansion as a therapeutic target in both clinical practice and research.
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| http://dx.doi.org/10.3340/jkns.2014.56.4.303 | DOI Listing |
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Article Synopsis
- Hematoma expansion (HE) occurs in a significant portion of patients with acute intracerebral hemorrhage (ICH), impacting their outcomes; the study focuses on the predictive accuracy of the Black-&-White (B&W) sign in identifying HE.
- In a multicenter cohort from the PREDICT study, the association between the B&W sign and HE was analyzed, revealing that patients with the B&W sign had a higher frequency of HE and more substantial growth of hematomas compared to those without it.
- The B&W sign strongly predicts HE, with an adjusted odds ratio of 7.83 for HE and 5.67 for severe HE, indicating that its presence significantly increases the risk of hematoma expansion.
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