Predictors of Hematoma Enlargement in Patients with Spontaneous Intracerebral Hemorrhage Treated with Rapid Administration of Antifibrinolytic Agents and Strict Conservative Management

Kim, Chang Hyeun; Lee, Sang Weon; Kim, Young Ha; Sung, Soon Ki; Son, Dong Wuk; Song, Geun Sung

Spot sign has been studied extensively in the last decade and might be the strongest individual predictor for subsequent hematoma expansion. One believable explanation is that spot sign might represent active bleeding or rebleeding in ruptured vessels, which reflects contrast extravasation on CT or MRI scans. 7) Recently, modified spot sign and black hole sign on non-enhance CT scans have been proposed as radiologic markers similar to spot sign, and these markers are also strongly associated with hematoma expansion and prognosis. 28) Other parameters including anticoagulant and antiplatelet medication did not indicate statistical significance. These results suggest that we had a small number of cases and those adjustable parameters, including BP and pain, were strictly managed according to the guidelines.