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KMID : 1001920140560040303
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Journal of Korean Neurosurgical Society
2014 Volume.56 No. 4 p.303 ~ p.309
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The Spot Sign Predicts Hematoma Expansion, Outcome, and Mortality in Patients with Primary Intracerebral Hemorrhage
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Han Ju-Hee
Lee Jong-Myong
Koh Eun-Jeong
Choi Ha-Young
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Abstract
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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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KEYWORD
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Intracerebral hemorrhage, Spot sign, Outcome, Mortality
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