Prediction and Observation of Post-Admission Hematoma Expansion in Patients with Intracerebral Haemorrhage
Post-admission hematoma expansion in patients with intracerebral haemorrhage (ICH) comprises a simultaneous major clinical problem and a possible target for medical intervention. In any case, the ability to predict and observe hematoma expansion is of great clinical importance. We review radiologica...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2014-09-01
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| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fneur.2014.00186/full |
| _version_ | 1819059799010050048 |
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| author | Christian eOvesen Inger eHavsteen Sverre eRosenbaum Hanne eChristensen |
| author_facet | Christian eOvesen Inger eHavsteen Sverre eRosenbaum Hanne eChristensen |
| author_sort | Christian eOvesen |
| collection | DOAJ |
| description | Post-admission hematoma expansion in patients with intracerebral haemorrhage (ICH) comprises a simultaneous major clinical problem and a possible target for medical intervention. In any case, the ability to predict and observe hematoma expansion is of great clinical importance. We review radiological concepts in predicting and observing post-admission hematoma expansion. Hematoma expansion can be observed within the first 24 hours after symptom onset, but predominantly occurs in the early hours. Thus capturing markers of on-going bleeding on imaging techniques could predict hematoma expansion. The spot sign observed on CTA is believed to represent on-going bleeding and is to date the most well investigated and reliable radiological predictor of hematoma expansion as well as functional outcome and mortality. On non-contrast CT, the presence of foci of hypoattenuation within the hematoma along with the hematoma-size is reported to be predictive of hematoma expansion and outcome. Because patients tend to arrive earlier to the hospital, a larger fraction of acute ICH-patients must be expected to undergo hematoma expansion. This renders observation and radiological follow-up investigations increasingly relevant. Transcranial duplex sonography has in recent years proven to be able to estimate hematoma volume with good precision and could be a valuable tool in bedside serial observation of acute ICH patients. Future studies will elucidate, if better prediction and observation of post-admission hematoma expansion can help select patients, who will benefit from haemostatic treatment. |
| first_indexed | 2024-12-21T14:16:50Z |
| format | Article |
| id | doaj.art-611716ddbe4a4c5c9e9adaf3d4db8600 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-21T14:16:50Z |
| publishDate | 2014-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-611716ddbe4a4c5c9e9adaf3d4db86002022-12-21T19:00:54ZengFrontiers Media S.A.Frontiers in Neurology1664-22952014-09-01510.3389/fneur.2014.00186108439Prediction and Observation of Post-Admission Hematoma Expansion in Patients with Intracerebral HaemorrhageChristian eOvesen0Inger eHavsteen1Sverre eRosenbaum2Hanne eChristensen3Copenhagen University Hospital - BispebjergCopenhagen University Hospital - BispebjergCopenhagen University Hospital - BispebjergCopenhagen University Hospital - BispebjergPost-admission hematoma expansion in patients with intracerebral haemorrhage (ICH) comprises a simultaneous major clinical problem and a possible target for medical intervention. In any case, the ability to predict and observe hematoma expansion is of great clinical importance. We review radiological concepts in predicting and observing post-admission hematoma expansion. Hematoma expansion can be observed within the first 24 hours after symptom onset, but predominantly occurs in the early hours. Thus capturing markers of on-going bleeding on imaging techniques could predict hematoma expansion. The spot sign observed on CTA is believed to represent on-going bleeding and is to date the most well investigated and reliable radiological predictor of hematoma expansion as well as functional outcome and mortality. On non-contrast CT, the presence of foci of hypoattenuation within the hematoma along with the hematoma-size is reported to be predictive of hematoma expansion and outcome. Because patients tend to arrive earlier to the hospital, a larger fraction of acute ICH-patients must be expected to undergo hematoma expansion. This renders observation and radiological follow-up investigations increasingly relevant. Transcranial duplex sonography has in recent years proven to be able to estimate hematoma volume with good precision and could be a valuable tool in bedside serial observation of acute ICH patients. Future studies will elucidate, if better prediction and observation of post-admission hematoma expansion can help select patients, who will benefit from haemostatic treatment.http://journal.frontiersin.org/Journal/10.3389/fneur.2014.00186/fullCerebral Angiographytranscranial ultrasonographyIntracranial haemorrhagecerebral haemorrhageX-ray computed tomography |
| spellingShingle | Christian eOvesen Inger eHavsteen Sverre eRosenbaum Hanne eChristensen Prediction and Observation of Post-Admission Hematoma Expansion in Patients with Intracerebral Haemorrhage Frontiers in Neurology Cerebral Angiography transcranial ultrasonography Intracranial haemorrhage cerebral haemorrhage X-ray computed tomography |
| title | Prediction and Observation of Post-Admission Hematoma Expansion in Patients with Intracerebral Haemorrhage |
| title_full | Prediction and Observation of Post-Admission Hematoma Expansion in Patients with Intracerebral Haemorrhage |
| title_fullStr | Prediction and Observation of Post-Admission Hematoma Expansion in Patients with Intracerebral Haemorrhage |
| title_full_unstemmed | Prediction and Observation of Post-Admission Hematoma Expansion in Patients with Intracerebral Haemorrhage |
| title_short | Prediction and Observation of Post-Admission Hematoma Expansion in Patients with Intracerebral Haemorrhage |
| title_sort | prediction and observation of post admission hematoma expansion in patients with intracerebral haemorrhage |
| topic | Cerebral Angiography transcranial ultrasonography Intracranial haemorrhage cerebral haemorrhage X-ray computed tomography |
| url | http://journal.frontiersin.org/Journal/10.3389/fneur.2014.00186/full |
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