Role of 'Spot Sign' on CT Angiography to Predict Hematoma Expansion in Spontaneous Intracerebral Hemorrhage

Traumatic Intracranial Hematomas: Prognostic Value of Contrast Extravasation

“…Akin to prior nontraumatic ICH studies [12][13][14][15][16][17][18][20][21][22]38 and a smaller cerebral contusion study, 25 our results demonstrate the prognostic value of contrast extravasation in traumatic intracrananial injuries. Similarly, earlier MR imaging series evaluated "enhancement" of traumatic intra-and extra-axial hematomas, also suggesting a predictive value of extravasation in this setting but were limited by significantly smaller sample sizes.…”

“…11 In nontraumatic ICHs, contrast extravasation on CTA has been shown to predict hematoma expansion, poor outcome, and mortality. [12][13][14][15][16][17][18][19][20][21][22][23] Despite CT reports dating back Ͼ30 years identifying contrast extravasation in traumatic head injuries, 24 there has been limited analysis of this sign in the setting of trauma. A recent study evaluated 22 patients with traumatic cerebral contusions and concluded that early parenchymal CE is associated with clinical progression, cerebral edema, clinical deterioration, and the need for subsequent surgery.…”

Computed Tomography Angiography in the Assessment of Patients With Stroke/TIA

“…58,59 Several studies have shown that the spot sign is an accurate and powerful predictor of hematoma expansion, mortality, and poor outcome in patients with primary ICH. [59][60][61] A positive spot sign is a serpiginous and/ or linearshaped contrast density located within the margin of a parenchymal hematoma and not present in the NCCT. It must not have any anatomical continuity with vasculature adjacent to the hemorrhage.…”

Contrast Extravasation on CT Angiography Predicts Hematoma Expansion and Mortality in Acute Traumatic Subdural Hemorrhage

“…[9][10][11][12][13][14][15] However, to date, no studies have assessed the frequency and predictive value of this important finding in patients with aSDH. In our emergency department, CTA of the head and neck is frequently performed in patients who present with craniocervical trauma to detect vascular injury.…”

“…In our emergency department, CTA of the head and neck is frequently performed in patients who present with craniocervical trauma to detect vascular injury. 15,16 Subsets of these patients also have an associated aSDH. This study aims to determine the frequency and predictive value for hematoma expansion and inhospital mortality of the CTA contrast extravasation in patients with aSDH.…”