Background: Spontaneous intracerebral hemorrhage (ICH) is the second most prevalent subtype of stroke and has high mortality and morbidity. The utility of radiographic features to predict secondary brain injury related to hematoma expansion (HE) or increased intracranial pressure has been highlighted in patients with ICH, including the computed tomographic angiography (CTA) spot sign and intraventricular hemorrhage (IVH). Understanding the pathophysiology of spot sign and IVH may help identify optimal therapeutic strategies. We examined factors related to the spot sign and IVH, including coagulation status, hematoma size, and location, and evaluated their prognostic value in patients with ICH.
Methods: Prospectively collected data from a single center between 2012 and 2015 were analyzed. Patients who underwent thromboelastography within 24 h of symptom onset and completed follow-up brain imaging and CTA within 48 h after onset were included for analysis. Multivariate logistic regression analyses were performed to identify determinants of the spot sign and IVH and their predictive value for HE, early neurological deterioration (END), in-hospital mortality, and functional outcome at discharge.
Results: Of 161 patients, 50 (31.1%) had a spot sign and 93 (57.8%) had IVH. In multivariable analysis, the spot sign was associated with greater hematoma volume (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00-1.03), decreased white blood cell count (OR 0.88; 95% CI 0.79-0.98), and prolonged activated partial thromboplastin time (OR 1.14; 95% CI 1.06-1.23). IVH was associated with greater hematoma volume (OR 1.02; 95% CI 1.01-1.04) and nonlobar location of hematoma (OR 0.23; 95% CI 0.09-0.61). The spot sign was associated with greater risk of all adverse outcomes. IVH was associated with an increased risk of END and reduced HE, without significant impact on mortality or functional outcome.
Conclusions: The spot sign and IVH are associated with specific hematoma characteristics, such as size and location, but are related differently to coagulation status and clinical course. A combined analysis of the spot sign and IVH can improve the understanding of pathophysiology and risk stratification after ICH.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s12028-022-01537-9 | 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!