The Spot Sign Predicts Hematoma Expansion, Outcome, and Mortality in Patients with Primary Intracerebral Hemorrhage.
10.3340/jkns.2014.56.4.303
- Author:
Ju Hee HAN
1
;
Jong Myong LEE
;
Eun Jeong KOH
;
Ha Young CHOI
Author Information
1. Department of Neurosurgery, Chonbuk National University Hospital and Medical School, Jeonju, Korea. nsjmlee@gmail.com
- Publication Type:Original Article
- Keywords:
Intracerebral hemorrhage;
Spot sign;
Outcome;
Mortality
- MeSH:
Angiography;
Cerebral Hemorrhage*;
Follow-Up Studies;
Hematoma*;
Hemorrhage;
Hospital Mortality;
Humans;
Logistic Models;
Mortality*;
Neurosurgery;
Retrospective Studies
- From:Journal of Korean Neurosurgical Society
2014;56(4):303-309
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The purpose of this study was to retrospectively review cases of intracerebral hemorrhage (ICH) medically treated at our institution to determine if the CT angiography (CTA) 'spot sign' predicts in-hospital mortality and clinical outcome at 3 months in patients with spontaneous ICH. METHODS: We conducted a retrospective review of all consecutive patients who were admitted to the department of neurosurgery. Clinical data of patients with ICH were collected by 2 neurosurgeons blinded to the radiological data and at the 90-day follow-up. RESULTS: Multivariate logistic regression analysis identified predictors of poor outcome; we found that hematoma location, spot sign, and intraventricular hemorrhage were independent predictors of poor outcome. In-hospital mortality was 57.4% (35 of 61) in the CTA spot-sign positive group versus 7.9% (10 of 126) in the CTA spot-sign negative group. In multivariate logistic analysis, we found that presence of spot sign and presence of volume expansion were independent predictors for the in-hospital mortality of ICH. CONCLUSION: The spot sign is a strong independent predictor of hematoma expansion, mortality, and poor clinical outcome in primary ICH. In this study, we emphasized the importance of hematoma expansion as a therapeutic target in both clinical practice and research.
