Dynamic ‘Spot Sign’ Resolution following INR Correction in a Patient with Warfarin-Associated Intracerebral Hemorrhage

Abstract

Hematoma expansion in intracerebral hemorrhage is associated with poor clinical outcome. The ‘spot sign’ is a radiological marker that is associated with hematoma expansion, and thought to represent active extravasation of contrast. This case demonstrates the use of dynamic CT angiography in identifying the time-dependent appearance of a spot sign in a patient with warfarin-associated intracerebral hemorrhage. Repeat imaging is also presented which verified cessation of the spot sign after INR correction.

Keywords

• Spot sign
• CT angiography
• Intracerebral hemorrhage