TY - JOUR
T1 - Anatomic pattern of intracerebral hemorrhage expansion
T2 - Relation to CT angiography spot sign and hematoma center
AU - Boulouis, Grégoire
AU - Dumas, Andrew
AU - Betensky, Rebecca A.
AU - Brouwers, H. Bart
AU - Fotiadis, Panagiotis
AU - Vashkevich, Anastasia
AU - Ayres, Alison
AU - Schwab, Kristin
AU - Romero, Javier M.
AU - Smith, Eric E.
AU - Viswanathan, Anand
AU - Goldstein, Joshua N.
AU - Rosand, Jonathan
AU - Gurol, M. Edip
AU - Greenberg, Steven M.
PY - 2014/4
Y1 - 2014/4
N2 - BACKGROUND AND PURPOSE - : We sought to identify baseline determinants of the anatomic pattern of hematoma expansion in patients with intracerebral hemorrhage and spot sign. METHODS - : We coregistered baseline and follow-up CT scans from 15 intracerebral hemorrhage patients and measured growth at each surface node from baseline to follow-up hematoma. We analyzed the effects of proximity to the spot sign or hematoma center on distance of expansion, controlling for covariates. RESULTS - : There was substantial node-to-node variation in the extent of expansion around each hematoma surface (mean coefficient of variation for expansion distance, 0.43; 95% confidence interval, 0.39-0.48), indicating nonuniform expansion. Closer proximity to the hematoma center was independently associated with increased expansion (0.185 mm greater expansion for each 1 mm closer to the center; P<0.0001). Closer proximity to the spot sign was not independently associated with increased expansion in models including both terms. CONCLUSIONS - : Hemorrhages expand nonuniformly around their surface with a tendency for greater expansion closer to their center. These findings provide a novel framework for analyzing mechanisms underlying hemorrhage growth and response to treatment.
AB - BACKGROUND AND PURPOSE - : We sought to identify baseline determinants of the anatomic pattern of hematoma expansion in patients with intracerebral hemorrhage and spot sign. METHODS - : We coregistered baseline and follow-up CT scans from 15 intracerebral hemorrhage patients and measured growth at each surface node from baseline to follow-up hematoma. We analyzed the effects of proximity to the spot sign or hematoma center on distance of expansion, controlling for covariates. RESULTS - : There was substantial node-to-node variation in the extent of expansion around each hematoma surface (mean coefficient of variation for expansion distance, 0.43; 95% confidence interval, 0.39-0.48), indicating nonuniform expansion. Closer proximity to the hematoma center was independently associated with increased expansion (0.185 mm greater expansion for each 1 mm closer to the center; P<0.0001). Closer proximity to the spot sign was not independently associated with increased expansion in models including both terms. CONCLUSIONS - : Hemorrhages expand nonuniformly around their surface with a tendency for greater expansion closer to their center. These findings provide a novel framework for analyzing mechanisms underlying hemorrhage growth and response to treatment.
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U2 - 10.1161/STROKEAHA.114.004844
DO - 10.1161/STROKEAHA.114.004844
M3 - Article
C2 - 24603066
AN - SCOPUS:84897459675
SN - 0039-2499
VL - 45
SP - 1154
EP - 1156
JO - Stroke
JF - Stroke
IS - 4
ER -