title: The active extravasation of contrast (spot sign) depicted on multidetector computed tomography angiography might predict structural vascular etiology and mortality in secondary intracranial hemorrhage.
abstract: OBJECTIVE
  Intracerebral hemorrhage (ICH) occurs in 10% to 15% of all strokes and is accompanied by high rates of mortality, disability, and neurological sequelae. Our aim was to assess the presence and prognostic implications of the active extravasation of contrast within the hemorrhage (spot sign) in a series of patients with secondary ICH.
  
  
  METHODS
  We analysed 59 subjects who arrived at a tertiary hospital with secondary ICH and a brain parenchyma hemorrhage greater than 2.0 cm in any axis.
  
  
  RESULTS
  Spot sign was observed in 11 subjects, including 8 patients with saccular aneurysm, 1 with arteriovenous malformation, 1 with coagulation disorder and 1 with venous sinus thrombosis. A 37.5% mortality rate was documented in the spot sign-negative group, whereas the presence of this imaging finding was followed by an 81.8% in-hospital mortality rate.
  
  
  CONCLUSIONS
  Spot sign was correlated with vascular etiology and was a predictor of mortality in our series of patients.
authors.affiliation: From the *Section of Neuroradiology Santa Casa de Misericórdia de São Paulo, São Paulo SP; †Section of Radiology, Federal University of Espírito Santo, Vitória ES; ‡Division of Neurosurgery, and §Division of Neurology, Santa Casa de Misericórdia de São Paulo, São Paulo SP, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Rosa Júnior
authors.forename: Antônio José
authors.initials: AJ
authors.lastname: da Rocha
authors.forename: Antônio Carlos Martins
authors.initials: AC
authors.lastname: Maia Júnior
authors.forename: Nelson
authors.initials: N
authors.lastname: Saade
authors.forename: Rubens José
authors.initials: RJ
authors.lastname: Gagliardi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests