Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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The Spot Sign Predicts Hematoma Expansion, Outcome, and Mortality in Patients with Primary Intracerebral Hemorrhage

  • Han, Ju-Hee (Department of Neurosurgery, Chonbuk National University Hospital and Medical School) ;
  • Lee, Jong-Myong (Department of Neurosurgery, Chonbuk National University Hospital and Medical School) ;
  • Koh, Eun-Jeong (Department of Neurosurgery, Chonbuk National University Hospital and Medical School) ;
  • Choi, Ha-Young (Department of Neurosurgery, Chonbuk National University Hospital and Medical School)
  • Received : 2014.01.22
  • Accepted : 2014.10.17
  • Published : 2014.10.28
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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.

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References

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