The Usefulness of Contrast Extravasation on CT Angiography in Spontaneous Intracerebral Hemorrhage.
- Author:
Han Joong KEUM
1
;
Kum WHANG
;
Chul HU
;
Hun Joo KIM
;
Soon Ki HONG
;
Jhin Soo PYEN
;
Hyun Ho JUNG
Author Information
1. Department of Neurosurgery, Yonsei University, Wonju College of Medicine, Korea. whangkum@yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Computed tomography angiography;
Intracerebral hemorrhage;
Extravasation
- MeSH:
Angiography*;
Brain;
Cerebral Hemorrhage*;
Cohort Studies;
Follow-Up Studies;
Hematoma;
Humans;
Retrospective Studies
- From:Korean Journal of Cerebrovascular Surgery
2007;9(4):238-242
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The authors investigated the clinical and radiographic characteristics of patients who exhibited contrast extravasation on initial computed tomographic angiography (CTA) and assessed the its association with hematoma expansion. METHODS: Ninety six patients who were diagnosed with intracerebral hemorrhage and who received CTA within 12 hours from initial onset of symptoms and who received a follow up brain CT within 48 hours from the initial CTA between April 2004 and March 2007 were retrospectively assessed. Contrast extravasation was defined as the presence of high-density material within the hematoma. Patients were classified into the extravasation and no extravasation groups. Clinical and radiographic variables were compared between the two groups. RESULTS: Fifteen patients (19%) demonstrated presence of extravasation on initial CTA. A significantly higher rate of hematoma expansion was seen in the extravasation group compared to the non extravasation group (47% vs 17%, p=0.027). Mean time from onset of symptoms to initial CTA was significantly shorter in the extravasation group (3.5+/-1.3 hours vs 7.6+/-2.5 hours, p<0.001). Also, detection of extravasation on CTA significantly correlated with time from symptom onset to intial CTA, especially when it was less than 4 hours (p>0.001). CONCLUSIONS: Earlier detection of extravasation using CTA may help in identifying possibly life threatening complications caused by hematoma expansion. However, a larger prospective cohort is warranted to validate this result.