title: Frequency and Predicting Factors on Chronic Expanding Intracerebral Hematoma in Spontaneous Intracerebral Hemorrhage.
abstract: BACKGROUND
  Chronic expanding intracerebral hematoma is a well-known complication of spontaneous intracerebral hemorrhage. However, because chronic expanding intracerebral hematoma is relatively rare, it has not been studied systemically. The purpose of this study was to characterize a patient population with chronic expanding intracerebral hematoma, and to identify the predictive factors for it.
  
  
  METHODS
  We retrospectively evaluated 112 patients with spontaneous putaminal hemorrhage who were treated at our institution between January 1, 2010 and December 31, 2015. Data on age, sex, Glasgow Coma Scale score, presence of intraventricular hemorrhage, and intracerebral hemorrhage volume were collected, and their predictive values for chronic expanding intracerebral hematoma were investigated. We also evaluated the predictive value of a characteristic radiological finding at onset called the "layer sign," which was represented as a fluid level adjacent to the clot.
  
  
  RESULTS
  Chronic expanding intracerebral hematoma was observed in 4 patients (4.9%) with spontaneous intracerebral hemorrhage. Only the layer sign was significantly related to chronic expanding intracerebral hematoma (P = .003), and was found to be independently associated with chronic expanding intracerebral hematoma in a multivariate analysis (odds ratio, 18.6; 95% confidence interval, 1.19-291.0; P = .037).
  
  
  CONCLUSIONS
  The frequency of chronic expanding intracerebral hematoma in those with spontaneous intracerebral hemorrhage was estimated at 4.9%. The layer sign was a useful factor for predicting chronic expanding intracerebral hematoma.
authors.affiliation: Department of Neurosurgery, Higashihiroshima Medical Center, Hiroshima, Japan. Electronic address: shimizu_kiyoharu@hiro-hosp.jp.
authors.forename: Kiyoharu
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Department of Neurosurgery, Higashihiroshima Medical Center, Hiroshima, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sadatomo
authors.affiliation: Department of Neurosurgery, Higashihiroshima Medical Center, Hiroshima, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hara
authors.affiliation: Department of Neurosurgery, Higashihiroshima Medical Center, Hiroshima, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Ohba
authors.affiliation: Department of Neurosurgery, Higashihiroshima Medical Center, Hiroshima, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yuki
authors.affiliation: Department of Neurosurgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kurisu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002908:Chronic Disease; D000072226:Computed Tomography Angiography; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D020146:Putaminal Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed
keywords: Chronic expanding intracerebral hematoma; encapsulated type; layer sign; liquefied type