title: Quantitative Intracerebral Hemorrhage Localization.
abstract: OBJECTIVE
  The location of intracerebral hemorrhage (ICH) is currently described in a qualitative way; we provide a quantitative framework for estimating ICH engagement and its relevance to stroke outcomes.
  
  
  METHODS
  We analyzed 111 patients with ICH from the Minimally Invasive Surgery Plus Recombinant-Tissue Plasminogen Activator for Intracerebral Evacuation (MISTIE) II clinical trial. We estimated ICH engagement at a population level using image registration of computed tomographic scans to a template and a previously labeled atlas. Predictive regions of National Institutes of Health Stroke Scale and Glasgow Coma Scale stroke severity scores, collected at enrollment, were estimated.
  
  
  RESULTS
  The percent coverage of the ICH by these regions strongly outperformed the reader-labeled locations. The adjusted R(2) almost doubled from 0.129 (reader-labeled model) to 0.254 (quantitative location model) for National Institutes of Health Stroke Scale and more than tripled from 0.069 (reader-labeled model) to 0.214 (quantitative location model). A permutation test confirmed that the new predictive regions are more predictive than chance: P<0.001 for National Institutes of Health Stroke Scale and P<0.01 for Glasgow Coma Scale.
  
  
  CONCLUSIONS
  Objective measures of ICH location and engagement using advanced computed tomographic imaging processing provide finer, objective, and more quantitative anatomic information than that provided by human readers.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00224770.
authors.affiliation: From the Department of Biostatistics, Bloomberg School of Public Health (J.M., E.M.S., A.E., C.M.C.) and Department of Neurology, Division of Brain Injury Outcomes (N.L.U., D.F.H.), Johns Hopkins Medical Institutions, Baltimore, MD; and Department of Neurosurgery, David Geffen School of Medicine at UCLA (N.M., P.V.). jmusche1@jhu.edu.
authors.forename: John
authors.initials: J
authors.lastname: Muschelli
authors.affiliation: From the Department of Biostatistics, Bloomberg School of Public Health (J.M., E.M.S., A.E., C.M.C.) and Department of Neurology, Division of Brain Injury Outcomes (N.L.U., D.F.H.), Johns Hopkins Medical Institutions, Baltimore, MD; and Department of Neurosurgery, David Geffen School of Medicine at UCLA (N.M., P.V.).
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Ullman
authors.affiliation: From the Department of Biostatistics, Bloomberg School of Public Health (J.M., E.M.S., A.E., C.M.C.) and Department of Neurology, Division of Brain Injury Outcomes (N.L.U., D.F.H.), Johns Hopkins Medical Institutions, Baltimore, MD; and Department of Neurosurgery, David Geffen School of Medicine at UCLA (N.M., P.V.).
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Sweeney
authors.affiliation: From the Department of Biostatistics, Bloomberg School of Public Health (J.M., E.M.S., A.E., C.M.C.) and Department of Neurology, Division of Brain Injury Outcomes (N.L.U., D.F.H.), Johns Hopkins Medical Institutions, Baltimore, MD; and Department of Neurosurgery, David Geffen School of Medicine at UCLA (N.M., P.V.).
authors.forename: Ani
authors.initials: A
authors.lastname: Eloyan
authors.affiliation: From the Department of Biostatistics, Bloomberg School of Public Health (J.M., E.M.S., A.E., C.M.C.) and Department of Neurology, Division of Brain Injury Outcomes (N.L.U., D.F.H.), Johns Hopkins Medical Institutions, Baltimore, MD; and Department of Neurosurgery, David Geffen School of Medicine at UCLA (N.M., P.V.).
authors.forename: Neil
authors.initials: N
authors.lastname: Martin
authors.affiliation: From the Department of Biostatistics, Bloomberg School of Public Health (J.M., E.M.S., A.E., C.M.C.) and Department of Neurology, Division of Brain Injury Outcomes (N.L.U., D.F.H.), Johns Hopkins Medical Institutions, Baltimore, MD; and Department of Neurosurgery, David Geffen School of Medicine at UCLA (N.M., P.V.).
authors.forename: Paul
authors.initials: P
authors.lastname: Vespa
authors.affiliation: From the Department of Biostatistics, Bloomberg School of Public Health (J.M., E.M.S., A.E., C.M.C.) and Department of Neurology, Division of Brain Injury Outcomes (N.L.U., D.F.H.), Johns Hopkins Medical Institutions, Baltimore, MD; and Department of Neurosurgery, David Geffen School of Medicine at UCLA (N.M., P.V.).
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Hanley
authors.affiliation: From the Department of Biostatistics, Bloomberg School of Public Health (J.M., E.M.S., A.E., C.M.C.) and Department of Neurology, Division of Brain Injury Outcomes (N.L.U., D.F.H.), Johns Hopkins Medical Institutions, Baltimore, MD; and Department of Neurosurgery, David Geffen School of Medicine at UCLA (N.M., P.V.).
authors.forename: Ciprian M
authors.initials: CM
authors.lastname: Crainiceanu
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed
keywords: Glasgow Coma Scale; cerebral hemorrhage; stroke; tomography, x-ray computed