title: Active extravasation of contrast within the hemorrhage (spot sign): a multidetector computed tomography finding that predicts growth and a worse prognosis in non-traumatic intracerebral hemorrhage.
abstract: Intracerebral hemorrhage (ICH) causes high rates of disability and neurological sequelae Objective To evaluate spot signs as predictors of expansion and worse prognosis in non-traumatic ICH in a Brazilian cohort. Method We used multidetector computed tomography angiography to study 65 consecutive patients (40 men, 61.5%), with ages varying from 33 to 89 years (median age 55 years). Clinical and imaging findings were correlated with the findings based on the initial imaging. Results Of the individuals who presented a spot sign, 73.7% died (in-hospital mortality), whereas in the absence of a spot sign the mortality rate was 43.0%. Although expansion of ICH was detected in 75% of the patients with a spot sign, expansion was observed in only 9.0% of the patients who did not present a spot sign. Conclusions The spot sign strongly predicted expansion in non-traumatic ICH and an increased risk of in-hospital mortality.
authors.affiliation: Santa Casa de Misericórdia de São Paulo, Section of Neuroradiology, São PauloSP, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Rosa Júnior
authors.forename: Antônio José da
authors.initials: AJ
authors.lastname: Rocha
authors.forename: Nelson
authors.initials: N
authors.lastname: Saade
authors.forename: Antônio Carlos Martins
authors.initials: AC
authors.lastname: Maia Júnior
authors.forename: Rubens José
authors.initials: RJ
authors.lastname: Gagliardi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography / Q000379:methods; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000401:mortality; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013997:Time Factors