title: Intracerebral Hematoma Morphologic Appearance on Noncontrast Computed Tomography Predicts Significant Hematoma Expansion.
abstract: OBJECTIVE
  Hematoma expansion in intracerebral hemorrhage is associated with higher morbidity and mortality. The computed tomography (CT) angiographic spot sign is highly predictive of expansion, but other morphological features of intracerebral hemorrhage such as fluid levels, density heterogeneity, and margin irregularity may also predict expansion, particularly in centres where CT angiography is not readily available.
  
  
  METHODS
  Baseline noncontrast CT scans from patients enrolled in the Predicting Hematoma Growth and Outcome in Intracerebral Hemorrhage Using Contrast Bolus CT (PREDICT) study were assessed for the presence of fluid levels and degree of density heterogeneity and margin irregularity using previously validated scales. Presence and grade of these metrics were correlated with the presence of hematoma expansion as defined by the PREDICT study on 24-hour follow-up scan.
  
  
  RESULTS
  Three hundred eleven patients were included in the analysis. The presence of fluid levels and increasing heterogeneity and irregularity were associated with 24-hour hematoma expansion (P=0.021, 0.003 and 0.049, respectively) as well as increases in absolute hematoma size. Fluid levels had the highest positive predictive value (50%; 28%-71%), whereas margin irregularity had the highest negative predictive value (78%; 71%-85). Noncontrast metrics had comparable predictive values as spot sign for expansion when controlled for vitamin K, antiplatelet use, and baseline National Institutes of Health Stroke Scale, although in a combined area under the receiver-operating characteristic curve model, spot sign remained the most predictive.
  
  
  CONCLUSIONS
  Fluid levels, density heterogeneity, and margin irregularity on noncontrast CT are associated with hematoma expansion at 24 hours. These markers may assist in prediction of outcomes in scenarios where CT angiography is not readily available and may be of future help in refining the predictive value of the CT angiography spot sign.
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.). Dylan.Blacquiere@HorizonNB.ca.
authors.forename: Dylan
authors.initials: D
authors.lastname: Blacquiere
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Demchuk
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Hazzaa
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Anirudda
authors.initials: A
authors.lastname: Deshpande
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: William
authors.initials: W
authors.lastname: Petrcich
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Richard I
authors.initials: RI
authors.lastname: Aviv
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: David
authors.initials: D
authors.lastname: Rodriguez-Luna
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Molina
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Silva Blas
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Imanuel
authors.initials: I
authors.lastname: Dzialowski
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Anna
authors.initials: A
authors.lastname: Czlonkowska
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Jean-Martin
authors.initials: JM
authors.lastname: Boulanger
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Cheemun
authors.initials: C
authors.lastname: Lum
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Gord
authors.initials: G
authors.lastname: Gubitz
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Vasantha
authors.initials: V
authors.lastname: Padma
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Jayanta
authors.initials: J
authors.lastname: Roy
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Carlos S
authors.initials: CS
authors.lastname: Kase
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Rohit
authors.initials: R
authors.lastname: Bhatia
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
authors.affiliation: From the Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.) and Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; Department of Neurology, National Neuroscience Institution, King Fahad Medical City, Riyadh, Saudi Arabia (M.A.-H.); Department of Neurology at Kasturba Medical College, Manipal, Karnataka, India (A.D.); Methods Centre, Department of Clinical Epidemiology (W.P.), Neuroradiology Section, Department of Diagnostic Imaging (C.L.), and Department of Medicine (Neurology) (D.D.), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada; Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (R.I.A.); Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.); Department of Neurology, Dr Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona (IDIBGi) Foundation, Girona, Spain (Y.S.B.); Department of Neurology, University of Dresden, Dresden, Germany (I.D.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Montreal, Canada (J.-M.B.); Department of Neurology, Dalhousie University, Halifax, Canada (G.G.); Department of Neurology, All India Institute of Medical Sciences, New Delhi, India (V.P., R.B.); Department of Neuromedicine, AMRI Neurosciences Centre, Mukundapur, India (J.R.); Department of Neurology, Boston Medical Center, MA (C.S.K.); and Division of Neurology, Department of Medicine, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada (D.B.).
authors.forename: Dar
authors.initials: D
authors.lastname: Dowlatshahi
mesh_terms: D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: angiography; cerebral hemorrhage; hematoma; stroke; vitamin K