Comparison of Satellite Sign and Island Sign in Predicting Hematoma Growth and Poor Outcome in Patients with Primary Intracerebral Hemorrhage

Deng, Lan; Zhang, Gang; Xiao, Wei; Yang, Wen‐Song; Li, Rui; Shen, Yiqing; Xie, Xiong‐Fei; Lv, Xin‐Ni; Li, Yu-Lun; Zhao, Libo; Lv, Fajin; Qin, Xinyue; Xie, Peng; Li, Qi

doi:10.1016/j.wneu.2019.03.273

Cited by 16 publications

(12 citation statements)

References 24 publications

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“…Recently, some noncontrast CT markers, including the black hole sign, island sign, swirl sign, and blend sign (defined as blending of hyperattenuating area and hypoattenuating region with a well-defined margin 14 ), have been reported to predict the hematoma expansion of ICH under conservative treatment. 13,20,21,23,[30][31][32] Among these radiological characteristics, island sign has been reported to predict short-term and long-term poor prognoses and mortality in ICH patients, 20,21,[30][31][32] and the blend sign is likely to be an independent risk factor for PRB in ICH patients. 13 However, in this study, these radiological characteristics had no significant correlation with either PRB or shortterm prognosis of patients with SCH.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Postoperative Rebleeding and Short-Term Prognosis of Spontaneous Cerebellar Hemorrhage

Shen

Shao

et al. 2021

RMHP

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Postoperative rebleeding (PRB) is one of the most severe complications after hematoma evacuation of spontaneous intracerebral hemorrhage (ICH). PRB has been proven to be an independent risk factor for poor prognosis. Previous studies have shown that spot sign and blend sign are independent risk factors for PRB of spontaneous ICH. However, the risk factors for PRB of spontaneous cerebellar hemorrhage (SCH) have not been elucidated. The aim of the present study was to investigate the possible risk factors for PRB and shortterm prognosis of patients with SCH. Patients and Methods: This study identified 62 patients with SCH who underwent hematoma evacuation in our department. Risk factors for PRB and short-term prognosis were identified by a univariable logistic regression model, and predictors with a P value of less than 0.05 were included in the multivariable logistic regression model to identify independent predictors. A receiver operating characteristic (ROC) curve was created to test the sensitivity and specificity of independent risk factors. Results: Hematoma volume was the only independent predictor of PRB (OR=15.14, 95% CI=1.08-213.1, P=0.044). The sensitivity and specificity of hematoma volume to PRB were 63.6% and 89.7%, respectively, and the cutoff value of hematoma volume was >29.3 mL. GCS score ≤8 (OR=5.131, 95% CI=1.030-25.554, P=0.046) and PRB (OR=13.17, 95% CI=1.316-131.798, P=0.028) were independent risk factors for poor prognosis of patients with SCH. The sensitivity and specificity of the GCS score to poor prognosis were 66.7% and 86.2%, respectively. The sensitivity and specificity of the PRB to poor prognosis were 36.4% and 96.6%, respectively. Conclusion: Hematoma volume is likely to be a strong predictor of PRB among patients with SCH. GCS scores ≤8 on arrival and PRB were significant predictors of short-term poor outcome.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Postoperative Rebleeding and Short-Term Prognosis of Spontaneous Cerebellar Hemorrhage

Shen

Shao

et al. 2021

RMHP

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“…The satellite sign is a small hemorrhage less than 10 mm in diameter and located within 20 mm of the main hematoma. It was present in 37-50% of patients and may be a useful predictor of hematoma expansion and poor functional outcomes, however, a meta-analysis demonstrated only a 50% sensitivity and 71% specificity for hematoma expansion [10][11][12][13]. Island sign is defined as at least three small hemorrhages separated from the main hematoma or at least 4 smaller hemorrhages connected to or separate from the main hematoma.…”

Section: Intracerebral Hemorrhage (Ich) Diagnosis and Imagingmentioning

confidence: 99%

“…Island sign is defined as at least three small hemorrhages separated from the main hematoma or at least 4 smaller hemorrhages connected to or separate from the main hematoma. It was present in 15-23% of patients and has also been shown to predict hematoma expansion and poor outcomes [12,[14][15][16]. Of note, one comparison study has suggested that the island sign is a better predictor of hematoma expansion than the satellite sign [12].…”

Section: Intracerebral Hemorrhage (Ich) Diagnosis and Imagingmentioning

confidence: 99%

“…It was present in 15-23% of patients and has also been shown to predict hematoma expansion and poor outcomes [12,[14][15][16]. Of note, one comparison study has suggested that the island sign is a better predictor of hematoma expansion than the satellite sign [12]. The swirl sign, black hole sign and blend sign are considered density markers [8,9].…”

Section: Intracerebral Hemorrhage (Ich) Diagnosis and Imagingmentioning

confidence: 99%

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Minimally Invasive Intracerebral Hemorrhage Evacuation Techniques: A Review

Hannah¹,

Kellner²,

Kellner³

2021

Diagnostics

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Intracerebral hemorrhage (ICH) continues to have high morbidity and mortality. Improving ICH outcomes likely requires rapid removal of blood from the parenchyma and restraining edema formation while also limiting further neuronal damage due to the surgical intervention. Minimally invasive surgery (MIS) approaches promise to provide these benefits and have become alluring options for management of ICH. This review describes six MIS techniques for ICH evacuation including craniopuncture, stereotactic aspiration with thrombolysis, endoport-mediated evacuation, endoscope-assisted evacuation, adjunctive aspiration devices, and the surgiscope. The efficacy of each modality is discussed based on current literature. The largest clinical trials have yet to demonstrate definitive effects of MIS intervention on mortality and functional outcomes for ICH. Thus, there is a significant need for further innovation for ICH treatment. Multiple ongoing trials promise to better clarify the potential of the newer, non-thrombolytic MIS techniques.

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“…The "island sign" is defined as scattered small hematomas apart from the main hematoma and the "blend sign" is defined as blending of a relatively hypoattenuating area with adjacent hyperattenuating region within a hematoma. The "black hole sign" is defined as a relatively hypoattenuating area (black hole) encapsulated within the hyperattenuating hematoma and the "satellite sign" is defined as small (maximal diameter <10 mm) hemorrhage close to but completely isolated from the main hemorrhage in at least a single slice 27,28,29,30,31 .…”

Section: Hematoma Expansionmentioning

confidence: 99%

Intracerebral hemorrhage: update and future directions

Rocha

Rouanet

Reges

et al. 2020

Arq. Neuro-Psiquiatr.

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Intracerebral hemorrhage (ICH), defined as bleeding into the brain parenchyma, is a significant public health issue. Although it accounts for only 10 to 15% of strokes, it is associated with the highest morbidity and mortality rates. Despite advances in the field of stroke and neurocritical care, the principles of acute management have fundamentally remained the same over many years. The main treatment strategies include aggressive blood pressure control, early hemostasis, reversal of coagulopathies, clot evacuation through open surgical or minimally invasive surgical techniques, and the management of raised intracranial pressure.

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Comparison of Satellite Sign and Island Sign in Predicting Hematoma Growth and Poor Outcome in Patients with Primary Intracerebral Hemorrhage

Cited by 16 publications

References 24 publications

Risk Factors for Postoperative Rebleeding and Short-Term Prognosis of Spontaneous Cerebellar Hemorrhage

Risk Factors for Postoperative Rebleeding and Short-Term Prognosis of Spontaneous Cerebellar Hemorrhage

Minimally Invasive Intracerebral Hemorrhage Evacuation Techniques: A Review

Intracerebral hemorrhage: update and future directions

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