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

The first CT was taken within 30 minutes of arrival to the emergency room, the second CT was taken within 48 hours, and the CT was taken early if there were any changes in neurological symptoms or the Glasgow coma scale score. Hematoma size was measured in the initial and second CT images. The maximal diameter was the longest measured intraparenchymal high density among the CT axial sections. The final lesion volume was calculated by multiplying the area obtained in each section by the slice thickness. Ventricular hemorrhage was excluded in the hematoma volume calculation because of calculation difficulties. Various definition for hematoma expansion has reported to be an increase in the hematoma volume of 20% to 50% from the baseline image to the second CT scan. 5,13,16) We defined hematoma expansion as an increase of more than 20% of the maximum diameter or increase of more than 20% in volume.