Background And Purpose: The computed tomography angiography spot sign is associated with hematoma expansion, case fatality, and poor functional outcome in spontaneous supratentorial intracerebral hemorrhage (ICH). However, no data are available on the spot sign in spontaneous cerebellar ICH.
Methods: We investigated consecutive patients with spontaneous cerebellar ICH at 3 academic hospitals between 2002 and 2017. We determined patient characteristics, hematoma expansion (>33% or 6 mL), rate of expansion, discharge and 90-day case fatality, and functional outcome. Poor functional outcome was defined as a modified Rankin Scale score of 4 to 6. Associations were tested using univariable and multivariable logistic regression.
Results: Three hundred fifty-eight patients presented with cerebellar ICH, of whom 181 (51%) underwent a computed tomography angiography. Of these 181 patients, 121 (67%) were treated conservatively of which 15 (12%) had a spot sign. Patients with a spot sign treated conservatively presented with larger hematoma volumes (median [interquartile range]: 26 [7–41] versus 6 [2–13], P=0.001) and higher speed of expansion (median [interquartile range]: 15 [24–3] mL/h versus 1 [5–0] mL/h, P=0.034). In multivariable analysis, presence of the spot sign was independently associated with death at 90 days (odds ratio, 7.6 [95% CI, 1.6–88], P=0.037). With respect to surgically treated patients (n=60, [33%]), 14 (23%) patients who underwent hematoma evacuation had a spot sign. In these 60 patients, patients with a spot sign were older (73.5 [9.2] versus 66.6 [15.4], P=0.047) and more likely to be female (71% versus 37%, P=0.033). In a multivariable analysis, the spot sign was independently associated with death at 90 days (odds ratio, 2.1 [95% CI, 1.1–4.3], P=0.033).
Conclusions: In patients with spontaneous cerebellar ICH treated conservatively, the spot sign is associated with speed of hematoma expansion, case fatality, and poor functional outcome. In surgically treated patients, the spot sign is associated with 90-day case fatality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1161/STROKEAHA.120.033297 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Leopard spot retinopathy represents the initial sign of rhegmatogenous retinal detachment in children: a report of two cases.
BMC Ophthalmol
December 2024
Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei Province, China.
Background: Leopard spots can appear in a variety of diseases; however, they are extremely rare in children with rhegmatogenous retinal detachment. This study presents two such rare cases in which leopard spot retinopathy was the initial manifestation of rhegmatogenous retinal detachment.
Case Presentation: Case 1 involved a 4-year-old boy had previously been diagnosed with left eye uveitis and received systemic steroid therapy at a local hospital, but symptoms persisted.
Usefulness of ocular ultrasound for monitoring acute retinal arterial ischemia.
Med Clin (Barc)
December 2024
Departamento de Medicina, Universidad de Sevilla, Sevilla, España; Servicio de Neurología, Hospital de Valme, Sevilla, España.
Introduction: The ocular ultrasound spot sign negatively predicts the success of thrombolytic treatment in retinal arterial occlusions. We evaluated the presence of the spot sign in these patients.
Material And Methods: Retrospective study of patients with acute central retinal artery occlusion (CRAO) or its branches (BRAO).
Validation of the Black-&-White sign to predict intracerebral hematoma expansion in the multi-center PREDICT study cohort.
Int J Stroke
December 2024
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
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.
Remineralization and anti-demineralization effect of orthodontic adhesives on enamel surrounding orthodontic brackets: a systematic review of in vitro studies.
BMC Oral Health
November 2024
Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Objective: White spot lesions are initial sign of enamel caries that compromise esthetic appearance following orthodontic treatment. Thus, the systematic review was conducted to evaluate the remineralization potential of orthodontic adhesives on early-enamel lesions surrounding orthodontic bracket.
Methods: Search strategy was performed through three databases (PubMed, Web of Science, and Scopus).
Is the Hyperdensity Areas of the CT Blend Sign Associated with the Fresh Bleeding in Intracerebral Hemorrhage?
Curr Med Imaging
November 2024
Department of Emergency, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, PR China.
Article Synopsis
- The study investigates the relationship between two features in Intracerebral Hemorrhage (ICH), the spot sign and the blend sign, aiming to clarify the mechanisms behind their formation.
- Researchers categorized patients based on the location of the spot sign within the blend sign and analyzed its association with hematoma expansion (HE) over a period from 2018 to 2023.
- Results showed that the majority of patients with a spot sign had it in the hyperdensity region, and this was a strong predictor of HE, suggesting that the hyperdensity area indicates active bleeding.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!