학술논문
Predicting Intracerebral Hemorrhage Growth With the Spot Sign
Document Type
article
Author
Dowlatshahi, Dar; Brouwers, H Bart; Demchuk, Andrew M; Hill, Michael D; Aviv, Richard I; Ufholz, Lee-Anne; Reaume, Michael; Wintermark, Max; Hemphill, J Claude; Murai, Yasuo; Wang, Yongjun; Zhao, Xingquan; Wang, Yilong; Li, Na; Sorimachi, Takatoshi; Matsumae, Mitsunori; Steiner, Thorsten; Rizos, Timolaos; Greenberg, Steven M; Romero, Javier M; Rosand, Jonathan; Goldstein, Joshua N; Sharma, Mukul
Source
Stroke. 47(3)
Subject
Language
Abstract
Background and purposeHematoma expansion after acute intracerebral hemorrhage is common and is associated with early deterioration and poor clinical outcome. The computed tomographic angiography (CTA) spot sign is a promising predictor of expansion; however, frequency and predictive values are variable across studies, possibly because of differences in onset-to-CTA time. We performed a patient-level meta-analysis to define the relationship between onset-to-CTA time and frequency and predictive ability of the spot sign.MethodsWe completed a systematic review for studies of CTA spot sign and hematoma expansion. We subsequently pooled patient-level data on the frequency and predictive values for significant hematoma expansion according to 5 predefined categorized onset-to-CTA times. We calculated spot-sign frequency both as raw and frequency-adjusted rates.ResultsAmong 2051 studies identified, 12 met our inclusion criteria. Baseline hematoma volume, spot-sign status, and time-to-CTA were available for 1176 patients, and 1039 patients had follow-up computed tomographies for hematoma expansion analysis. The overall spot sign frequency was 26%, decreasing from 39% within 2 hours of onset to 13% beyond 8 hours (P