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'Spotting' patients at the highest risk of hematoma growth

Nature Reviews Neurology volume 5, pages 526–528 (2009)Cite this article

Clinical trials aimed at preventing hematoma expansion in patients with intraparenchymal hemorrhage have failed to show benefit from experimental intervention. Novel methods for identifying those patients at the highest risk of hemorrhage growth might enable better patient selection and, hence, increase the chance of demonstrating an improvement in clinical outcome.

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Figure 1: Spot sign in a patient with intraparenchymal hemorrhage.

References

  1. Dennis, M. S. Outcome after brain haemorrhage. Cerebrovasc. Dis. 16 (Suppl. 1), 9–13 (2003).

    Article  PubMed  Google Scholar 

  2. Brott, T. et al. Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke 28, 1–5 (1997).

    Article  CAS  PubMed  Google Scholar 

  3. Mayer, S. A. et al. Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage. N. Engl. J. Med. 358, 2127–2137 (2008).

    Article  CAS  PubMed  Google Scholar 

  4. Anderson, C. S. et al. Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial. Lancet Neurol. 7, 391–399 (2008).

    Article  PubMed  Google Scholar 

  5. Delgado Almandoz, J. E. et al. Systematic characterization of the computed tomography angiography spot sign in primary intracerebral hemorrhage identifies patients at highest risk for hematoma expansion. The spot sign score. Stroke doi:10.1161/STROKEAHA.109.554667.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Wada, R. et al. CT angiography “spot sign” predicts hematoma expansion in acute intracerebral hemorrhage. Stroke 38, 1257–1262 (2007).

    Article  PubMed  Google Scholar 

  7. Goldstein, J. N. et al. Contrast extravasation on CT angiography predicts hematoma expansion in intracerebral hemorrhage. Neurology 68, 889–894 (2007).

    Article  CAS  PubMed  Google Scholar 

  8. Becker, K. J. et al. Extravasation of radiographic contrast is an independent predictor of death in primary intracerebral hemorrhage. Stroke 30, 2025–2032 (1999).

    Article  CAS  PubMed  Google Scholar 

  9. Stroke Trials Registry STOP-IT. The Spot Sign for Predicting and Treating ICH Growth Study [online], (2009).

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Author notes

  1. K. Becker, Harborview Medical Center, Box 359775, 325 9th Avenue, Seattle, WA 98104–2499, USA kjb@u.washington.edu

Authors and Affiliations

  1. University of Washington School of Medicine, Harborview Medical Center, Seattle, WA, USA

    Kyra Becker & David Tirschwell

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  1. Kyra Becker
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  2. David Tirschwell
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Competing interests

D. Tirschwell has received has received grant support from Novo Nordisk. K. Becker declares no competing interests.

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Becker, K., Tirschwell, D. 'Spotting' patients at the highest risk of hematoma growth. Nat Rev Neurol 5, 526–528 (2009). https://doi.org/10.1038/nrneurol.2009.152

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