Is Extravasation of Radiographic Contrast a Predictor of Hematoma Enlargement in Spontaneous Supratentorial Intracerebral Hemorrhage?.
- Author:
Young Woo KIM
1
;
Won Ki YOON
;
Seoung Rim KIM
;
Sang Don KIM
;
Ik Seong PARK
;
Min Woo BAIK
;
Seung Hoon YOU
Author Information
1. Department of Neurosurgery, Holy Family Hospital, The Catholic University of Korea, Korea.
- Publication Type:Original Article
- Keywords:
Extravasation;
Hematoma Enlargement;
Spontaneous;
Intracerebral Hemorrhage
- MeSH:
Basal Ganglia;
Cerebral Hemorrhage*;
Follow-Up Studies;
Hematoma*;
Hospitalization;
Humans;
Thalamus;
Tomography, X-Ray Computed
- From:Korean Journal of Cerebrovascular Surgery
2007;9(4):252-258
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: The enlargement of a hematoma occurs commonly in patients with spontaneous intracerebral hemorrhage (ICH) after hospitalization and can worsen the clinical outcome. We conducted this study to determine whether extravasation of a radiographic contrast agent is a predictor of hematoma enlargement occurring after admission in patients with spontaneous ICH. METHODS: We reviewed the clinical records and computerized tomography (CT) scan findings of 384 patients with spontaneous ICH admitted within 24 hours of ictus from 2002 to 2005. Only 71 patients with primary ICH in the basal ganglia or thalamus were included in the study. The first CT scan was preformed within 24 hours of onset and the second CT scan was preformed within 72 hours of onset. We compared patients with and without hematoma enlargement according to the radiological findings, clinical characteristics and laboratory data. RESULTS: Seventeen patients (23.9%) showed hematoma enlargement after admission. Extravasation of the radiographic contrast agent on a CT scan was seen in 23 patients (32.4%). The presence of contrast extravasation on a CT scan closely correlated with evidence of hematoma enlargement, as seen on a follow-up CT scan (p = 0.000). Other variables did not reach statistical significance for the independent association with hematoma enlargement. CONCLUSIONS: Due to a high risk for hematoma enlargement, patients with spontaneous ICH in the basal ganglia and thalamus, especially those with evidence of contrast extravasation on a CT scan, should be closely observed. Short term followup radiological studies are needed for the verification of hematoma enlargement.
