Low occurrence of “spot sign” on computed tomography angiography in acute intracerebral hemorrhage: A single-center prospective study from India

Abstract

Background: Intracerebral hemorrhage (ICH) has high mortality and morbidity. The “spot sign” on three-dimensional computerized tomography angiography (3D-CTA) has been associated with hematoma expansion and poorer outcomes. The occurrence of “spot sign” in the Indian population is poorly studied. This study was done to explore the occurrence of “spot sign” in Indian patients with ICH and their outcomes. Methods: Patients with ICH presenting within 48 h from onset to the stroke unit were recruited. They underwent noncontrast computerized tomography (NCCT) head followed by 3D-CTA and a repeat NCCT head before discharge, surgery, or with clinical worsening within 7 days of presentation. Hematoma volume was calculated using the ABC/2 method. The primary outcome was modified Rankin Scale at 3 months. Results were analyzed using descriptive statistics, Fisher's exact test, independent t- test, and Mann–Whitney U-test. The analysis was performed using SPSS version 21. P < 0.05 was taken as statistically significant. Results: Fifty-four patients were recruited during the study period, and only three patients (5.6%) had “spot sign.” All patients with “spot sign” had poor outcome without hematoma expansion. Conclusion: This study shows a low occurrence of “spot sign” in patients with ICH than previously reported. All patients with “spot sign” showed poor outcome.

Keywords

• hematoma expansion
• intracerebral hemorrhage
• spot sign