Computed Tomographic Black Hole Sign Predicts Postoperative Rehemorrhage in Patients with Spontaneous Intracranial Hemorrhage Following Stereotactic Minimally Invasive Surgery

Shen, Zhengkui; Wang, Likun; Wu, Guofeng; Li, Qi; Ren, Siying; Mao, Yuanhong

doi:10.1016/j.wneu.2018.07.256

Cited by 22 publications

(18 citation statements)

References 28 publications

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“…an increased risk of the BS. The BS and BHS were found to be associated with a higher risk of postoperative rebleeding in sICH patients undergoing surgical intervention (33,40,41), and this also indirectly confirmed the underlying mechanisms of HE. Therefore, the presence of the BS combined with larger baseline hematoma volume could identify those patients most likely to benefit from anti-HE therapies.…”

Section: Figure 4 |mentioning

confidence: 57%

Blend Sign Is a Strong Predictor of the Extent of Early Hematoma Expansion in Spontaneous Intracerebral Hemorrhage

et al. 2020

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Background and Purpose: It is unclear which imaging marker is optimal for predicting the extent of hematoma expansion (EHE). We aimed to compare the usefulness of the blend sign (BS) with that of other non-contrast computed tomography (NCCT) markers for predicting the EHE in patients with spontaneous intracerebral hemorrhage (sICH). Methods: Patients with sICH admitted to our Neurology Emergency Department between September 2013 and January 2019 were enrolled. The EHE was calculated as the absolute increase in hematoma volume between baseline and follow-up CT (within 72 h). The EHE was categorized into four groups: "no growth," "minimal change" (≤5.1 ml), "moderate change" (5.1-12.5 ml), and "massive change" (>12.5 ml). Univariate and multivariate analyses were performed to investigate the relationship between the NCCT markers [BS, black hole sign (BHS), satellite sign, and island sign] and the EHE. Results: A total of 1,111 sICH patients were included (median age: 60 years; 66.5% males). Multiple linear regression analysis showed that the presence of the BS and BHS was independently associated with the EHE, after adjusting for confounders (P < 0.001 and P = 0.003, respectively). The presence of the BS and BHS was positively correlated with growth category (r = 0.285 and r = 0.199, both Ps < 0.001). The BS demonstrated a better predictive performance for the EHE than did the BHS [area under the curve (AUC): 0.67 vs. 0.57; both Ps < 0.001]. Conclusions: In patients with acute sICH, the BS showed a better performance in predicting the EHE compared with other NCCT markers. This imaging marker may help identify patients at a high risk of significant hematoma expansion and may facilitate its early management.

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Section: Figure 4 |mentioning

confidence: 57%

Blend Sign Is a Strong Predictor of the Extent of Early Hematoma Expansion in Spontaneous Intracerebral Hemorrhage

et al. 2020

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“…The time from onset to baseline CT was 5.0 (2.0-9.7) hours. The mean admission GCS score was 11 (8)(9)(10)(11)(12)(13), and the mean NIHSS score was 16 (14)(15)(16)(17)(18)(19)(20). One hundred eighty-four patients showed haematoma in the basal ganglia area, 34 patients in the cerebral lobes, and 24 patients in the thalamus.…”

Section: Resultsmentioning

confidence: 99%

“…The blend sign showed an association with poor outcome in patients with a small volume of ICH treated with medications 2 . Our previous studies showed that the black hole sign and the blend sign predicted re-haemorrhage in patients with hypertensive ICH who underwent stereotactic minimally invasive surgery (sMIS) 14,15 . However, whether the initial CT blend signs are associated with poor outcome in patients following sMIS remains unknown.…”

Section: Introductionmentioning

confidence: 99%

CT scan blend signs are not associated with poor outcome in patients with ICH who undergo stereotactic minimally invasive surgery

Zhu

Zhang

et al. 2020

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Background: The initial CT blend sign has been used as an imaging marker to predict haematoma expansion and poor outcomes in patients with a small volume intracerebral haemorrhage (ICH). However, the relationship between the blend sign and outcomes remains elusive. The present study aimed to retrospectively measure the impact of initial CT blend signs on short-term outcomes in patients with hypertensive ICH who underwent stereotactic minimally invasive surgery (sMIS). Methods: We enrolled 242 patients with spontaneous ICH. Based on the initial CT features, the patients were assigned to a blend sign group (91 patients) or a non-blend sign (control) group (151 patients). The NIHSS, GCS and mRS were used to measure the efficacy of the sMIS. The rates of severe pulmonary infection and cardiac complications were also compared between the two groups. Results: No significant differences in NIHSS and GCS at one week or two weeks after surgery were observed between the two groups. The proportion of patients with good outcomes during follow-up was not different in the two groups. Both groups displayed good functional outcomes relative to the state at admission. The rate of re-haemorrhaging increased in the blend sign group. No significant differences in severe pulmonary infections and cardiac complications were noted between the two groups. Conclusions: The initial CT blend sign was not associated with poor outcome in patients with hypertensive ICH who underwent sMIS. ICH patients with CT blend signs should undergo sMIS if they are suitable candidates for surgery.

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“…The time from onset to baseline CT was 5.0 (2.0-9.7) hours. The admission GCS score was 10.62±5.903/ 11 (8)(9)(10)(11)(12)(13), and the NIHSS score was 17.02±5.544/16 (14)(15)(16)(17)(18)(19)(20). One hundred eighty-four patients showed haemaotma in basal ganglia area, 34 patients in cerebral lobes, and 24 patients in thalamus.…”

Section: The Baseline Datamentioning

confidence: 99%

“…The blend sign showed association with poor outcome in patients with small volume of ICH treated by medications 2 . Our previously studies showed that the black hole sign and the blend sign predicted rehaemorrhage in patients with hypertensive ICH underwent stereotactic minimally invasive surgery(sMIS) 14,15 . However, whether the initial CT blend signs are associated with poor outcome in patients following sMIS is unknown.…”

Section: Introductionmentioning

confidence: 99%

CT Blend Signs are not Associated with Poor Outcome in Patients with ICH Following a Stereotactic Minimally Invasive Surgery

Zhang

Wang

et al. 2020

Preprint

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Abstract Backgrounds: The initial CT blend sign has been used as an imaging maker to predict haematoma expansion and poor outcome in patients with small volume intracerebral haemorrhage (ICH). However, the relationship between the blend sign and the outcome of patients remains elusive. The present study aimed to retrospectively observe the impact of initial CT blend signs on the short-term outcome of patients with hypertensive ICH underwent a stereotatic minimally invasive surgery (sMIS). Methods: Two hundreds and forty-two patients with spontaneous ICH were enrolled. Based on the initial CT features, the patients were assigned to a blend sign group (including 91 patients) or a non-blend sign group (control group, including 151 patients). The NIHSS, GCS and the mRS were used to observe the efficacy of the sMIS. The rates of severe pulmonary infection, cardiac complications were also compared between the two groups. Results: No significant differences in NIHSS and GCS in one week or two weeks after surgery were observed between the two groups. The proportion of patients with good outcome during follow-up did not show any difference between the two groups. However, both the two groups displayed good functional outcome over admission. The rate of rehaemorrhage increased in the blend sign group. No significant differences in severe pulmonary infections and cardiac complications were noted between the two groups. Conclusions：The initial CT blend sign are not associated with poor outcome of patients with hypertensive ICH underwent sMIS. ICH patients with CT blend sign should be also treated by performing sMIS if they are candidates for surgery.

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Computed Tomographic Black Hole Sign Predicts Postoperative Rehemorrhage in Patients with Spontaneous Intracranial Hemorrhage Following Stereotactic Minimally Invasive Surgery

Cited by 22 publications

References 28 publications

Blend Sign Is a Strong Predictor of the Extent of Early Hematoma Expansion in Spontaneous Intracerebral Hemorrhage

Blend Sign Is a Strong Predictor of the Extent of Early Hematoma Expansion in Spontaneous Intracerebral Hemorrhage

CT scan blend signs are not associated with poor outcome in patients with ICH who undergo stereotactic minimally invasive surgery

CT Blend Signs are not Associated with Poor Outcome in Patients with ICH Following a Stereotactic Minimally Invasive Surgery

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