Follow the monthly scan of all major neurosurgical journals with abstracts

Message from NEUROSURGIC

Please observe that

we do not have the possibilty to

add more conferences

for the moment


Journal scan

Risk factors for computed tomography angiography spot sign in deep and lobar intracerebral hemorrhage are shared.

Radmanesh F, Falcone GJ, Anderson CD, Battey TW, Ayres AM, Vashkevich A, McNamara KA, Schwab K, Romero JM, Viswanathan A, Greenberg SM, Goldstein JN, Rosand J, Brouwers HB.

Stroke 45(6):1833-5, 2014. doi: 10.1161/STROKEAHA.114.005276.




Patients with intracerebral hemorrhage (ICH) who present with a spot sign on computed tomography angiography are at increased risk of hematoma expansion and poor outcome. Because primary ICH is the acute manifestation of chronic cerebral small vessel disease, we investigated whether different clinical or imaging characteristics predict spot sign presence, using ICH location as a surrogate for arteriolosclerosis- and cerebral amyloid angiopathy-related ICH.


Patients with primary ICH and available computed tomography angiography at presentation were included. Predictors of spot sign were assessed using uni- and multivariable regression, stratified by ICH location.


Seven hundred forty-one patients were eligible, 335 (45%) deep and 406 (55%) lobar ICH. At least one spot sign was present in 76 (23%) deep and 102 (25%) lobar ICH patients. In multivariable regression, warfarin (odds ratio [OR], 2.42; 95% confidence interval [CI], 1.01-5.71; P=0.04), baseline ICH volume (OR, 1.20; 95% CI, 1.09-1.33, per 10 mL increase; P<0.001), and time from symptom onset to computed tomography angiography (OR, 0.89; 95% CI, 0.80-0.96, per hour; P=0.009) were associated with the spot sign in deep ICH. Predictors of spot sign in lobar ICH were warfarin (OR, 3.95; 95% CI, 1.87-8.51; P<0.001) and baseline ICH volume (OR, 1.20; 95% CI, 1.10-1.31, per 10 mL increase; P<0.001).


The most potent associations with spot sign are shared between deep and lobar ICH, suggesting that the acute bleeding process that arises in the setting of different chronic small vessel diseases shares commonalities.


cerebral amyloid angiopathy; cerebral small vessel disease; computed tomography angiography; hypertension; intracerebral hemorrhage; spot sign


Buy full article: http://stroke.ahajournals.org/content/45/6/1833.long

Comments (0)Add Comment

Write commentWrite Comment

You must be logged in to post a comment. Please register if you do not have an account yet.

You are here: