Hematoma Volume Affects the Accuracy of Computed Tomographic Angiography ‘Spot Sign’ in Predicting Hematoma Expansion after Acute Intracerebral Hemorrhage

2011 ◽  
Vol 65 (3) ◽  
pp. 150-155 ◽  
Author(s):  
Yue-Hua Wang ◽  
Jin-Yu Fan ◽  
Guang-Dong Luo ◽  
Tie Lin ◽  
De-Xuan Xie ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Computed Tomographic Angiography ◽  
Hematoma Expansion ◽  
Hematoma Volume ◽  
Spot Sign ◽  
Computed Tomographic ◽  
Acute Intracerebral Hemorrhage ◽  
Tomographic Angiography

Acute intracerebral hemorrhage with a spot sign during computed tomographic angiography

2016 ◽  
Vol 16 (8) ◽  
pp. 976-977
Author(s):  
Kwang Hoon Kim ◽  
Hyun Goo Kang ◽  
Seong Hwan Ahn ◽  
Ji Yeon Chung ◽  
In Sung Choo ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Computed Tomographic Angiography ◽  
Spot Sign ◽  
Computed Tomographic ◽  
Acute Intracerebral Hemorrhage ◽  
Tomographic Angiography

scholarly journals Rate of Contrast Extravasation on Computed Tomographic Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage

Stroke ◽  
2015 ◽  
Vol 46 (9) ◽  
pp. 2498-2503 ◽  
Author(s):  
H. Bart Brouwers ◽  
Thomas W.K. Battey ◽  
Hayley H. Musial ◽  
Viesha A. Ciura ◽  
Guido J. Falcone ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Computed Tomographic Angiography ◽  
Hematoma Expansion ◽  
Contrast Extravasation ◽  
Computed Tomographic ◽  
Tomographic Angiography

scholarly journals Prospective Validation of the Computed Tomographic Angiography Spot Sign Score for Intracerebral Hemorrhage

Stroke ◽  
2013 ◽  
Vol 44 (11) ◽  
pp. 3097-3102 ◽  
Author(s):  
Javier M. Romero ◽  
H. Bart Brouwers ◽  
JingJing Lu ◽  
Josser E. Delgado Almandoz ◽  
Hillary Kelly ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Computed Tomographic Angiography ◽  
Spot Sign ◽  
Computed Tomographic ◽  
Tomographic Angiography

scholarly journals Integration of Computed Tomographic Angiography Spot Sign and Noncontrast Computed Tomographic Hypodensities to Predict Hematoma Expansion

Stroke ◽  
2018 ◽  
Vol 49 (9) ◽  
pp. 2067-2073 ◽  
Author(s):  
Andrea Morotti ◽  
Gregoire Boulouis ◽  
Andreas Charidimou ◽  
Kristin Schwab ◽  
Christina Kourkoulis ◽  
...  
Keyword(s):  
Computed Tomographic Angiography ◽  
Hematoma Expansion ◽  
Spot Sign ◽  
Computed Tomographic ◽  
Tomographic Angiography

scholarly journals Comparison of CTA to DSA in Determining the Etiology of Spontaneous ICH

2009 ◽  
Vol 36 (2) ◽  
pp. 176-180 ◽  
Author(s):  
Robert Yeung ◽  
Tabassum Ahmad ◽  
Richard I. Aviv ◽  
Lyne Noel de Tilly ◽  
Allan J. Fox ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Predictive Value ◽  
Computed Tomographic Angiography ◽  
Lower Sensitivity ◽  
Study Cohort ◽  
Computed Tomographic ◽  
Arteriovenous Fistulas ◽  
Kappa Value ◽  
Sensitivity Specificity ◽  
Tomographic Angiography

Background and Purpose:To compare the efficacy of computed tomographic angiography (CTA) to that of digital subtraction angiography (DSA) in the detection of secondary causes of intracerebral hemorrhage (ICH).Methods:Between January 2001 and February 2007 there were 286 patients that had both CTA and DSA for intracranial hemorrhage of all types. Those with primarily subarachnoid hemorrhage or recent trauma were excluded. Fifty-five patients formed the study cohort. Three reviewers independently analyzed the CTAs in a blinded protocol and classified them based on presence or absence of a secondary etiology. Results were compared with the reference standard DSA and kappa values determined for interobserver variability.Results:The overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CTA were 89%, 92%, 91%, 91% and 91%, respectively. Kappa value for interobserver agreement ranged from 0.78 to 0.89. Two of four dural arteriovenous fistulas (dAVF) were missed on CTA by all three reviewers.Conclusion:CTA is nearly as effective as DSA at determining the cause of secondary intracerebral hemorrhage, but with a lower sensitivity for dAVFs. This supports the use of CTA as the first screening test in patients presenting with spontaneous ICH.

scholarly journals Tranexamic Acid for Prevention of Hematoma Expansion in Intracerebral Hemorrhage Patients With or Without Spot Sign

Stroke ◽  
2021 ◽  
Author(s):  
Christian Ovesen ◽  
Janus Christian Jakobsen ◽  
Christian Gluud ◽  
Thorsten Steiner ◽  
Zhe Law ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intracerebral Hemorrhage ◽  
Tranexamic Acid ◽  
Symptom Onset ◽  
Odds Ratio ◽  
Hematoma Expansion ◽  
Spot Sign ◽  
Main Trial ◽  
Acid Versus ◽  
Acute Intracerebral Hemorrhage

Background and Purpose: The computed tomography angiography or contrast-enhanced computed tomography based spot sign has been proposed as a biomarker for identifying on-going hematoma expansion in patients with acute intracerebral hemorrhage. We investigated, if spot-sign positive participants benefit more from tranexamic acid versus placebo as compared to spot-sign negative participants. Methods: TICH-2 trial (Tranexamic Acid for Hyperacute Primary Intracerebral Haemorrhage) was a randomized, placebo-controlled clinical trial recruiting acutely hospitalized participants with intracerebral hemorrhage within 8 hours after symptom onset. Local investigators randomized participants to 2 grams of intravenous tranexamic acid or matching placebo (1:1). All participants underwent computed tomography scan on admission and on day 2 (24±12 hours) after randomization. In this sub group analysis, we included all participants from the main trial population with imaging allowing adjudication of spot sign status. Results: Of the 2325 TICH-2 participants, 254 (10.9%) had imaging allowing for spot-sign adjudication. Of these participants, 64 (25.2%) were spot-sign positive. Median (interquartile range) time from symptom onset to administration of the intervention was 225.0 (169.0 to 310.0) minutes. The adjusted percent difference in absolute day-2 hematoma volume between participants allocated to tranexamic versus placebo was 3.7% (95% CI, −12.8% to 23.4%) for spot-sign positive and 1.7% (95% CI, −8.4% to 12.8%) for spot-sign negative participants ( P heterogenity =0.85). No difference was observed in significant hematoma progression (dichotomous composite outcome) between participants allocated to tranexamic versus placebo among spot-sign positive (odds ratio, 0.85 [95% CI, 0.29 to 2.46]) and negative (odds ratio, 0.77 [95% CI, 0.41 to 1.45]) participants ( P heterogenity =0.88). Conclusions: Data from the TICH-2 trial do not support that admission spot sign status modifies the treatment effect of tranexamic acid versus placebo in patients with acute intracerebral hemorrhage. The results might have been affected by low statistical power as well as treatment delay. REGISTRATION: URL: http://www.controlled-trials.com ; Unique identifier: ISRCTN93732214.

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