title: Risks and benefits of CT angiography in spontaneous intracerebral hemorrhage.
abstract: BACKGROUND
  Few studies have examined the risk of computed tomography angiography (CTA) during the acute phase of spontaneous intracerebral hemorrhage (ICH), while the benefits of CTA in ICH have been well-documented. The present study investigated both the benefits of identifying spot signs, which are supposed to indicate hematoma enlargement after admission, and risks of CTA performed during the acute phase of ICH.
  
  
  METHODS
  We retrospectively assessed 323 consecutive patients with spontaneous ICHs admitted to our hospital between April 2009 and March 2012 and who underwent CTA on admission.
  
  
  RESULTS
  In 80 patients (24.7 %), spot signs were demonstrated on CTA source images. Multivariate analysis revealed two independent factors correlated with presence of the spot sign: age and hematoma volume (p < 0.05 each). The presence of spot sign was associated with unfavorable outcomes at discharge and hematoma growth after admission (p < 0.05 each). Adverse events related to CTA occurred in 17 patients (5.2 %), including transient renal dysfunction in 16 patients and allergy to contrast medium in one patient. All adverse events completely resolved within 1 week.
  
  
  CONCLUSIONS
  Presence of the spot sign indicated the possibility of hematoma growth and unfavorable outcomes. A small number of adverse events occurred in association with CTA, but without any permanent deficits. Given the potential benefits and risks, we believe that CTA performed at admission in all patients with ICH is beneficial to improve the outcomes.
authors.affiliation: Department of Neurosurgery, Tokai University School of Medicine, Shimokasuya 143, Isehara City, Kanagawa, 259-1193, Japan, k-hotta@mri.biglobe.ne.jp.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Hotta
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Sorimachi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Osada
authors.forename: Tanefumi
authors.initials: T
authors.lastname: Baba
authors.forename: Go
authors.initials: G
authors.lastname: Inoue
authors.forename: Hideki
authors.initials: H
authors.lastname: Atsumi
authors.forename: Hideo
authors.initials: H
authors.lastname: Ishizaka
authors.forename: Minako
authors.initials: M
authors.lastname: Matsuda
authors.forename: Naokazu
authors.initials: N
authors.lastname: Hayashi
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Matsumae
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography / Q000009:adverse effects*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging*; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010351:Patient Discharge; D011237:Predictive Value of Tests; D020146:Putaminal Hemorrhage / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000009:adverse effects
chemical_list: D003287:Contrast Media