INVESTIGATION OF SELECTED PREDICTIVE FACTORS FOR HEMATOMA EXPANSION IN PATIENTS WITH PRIMARY INTRACEREBRAL HEMORRHAGE
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Abstract
Objectives: To evaluate the predictive value of the Spot sign and Spot sign score (SSS) on computed tomography angiography (CTA) and some other factors to forecast hematoma expansion (HE) in patients with primary intracerebral hemorrhage (ICH). Methods: A retrospective, prospective, and cross-sectional descriptive, controlled study was conducted on 116 ICH patients treated at Military Hospital 103 between January 2023 and April 2025. CTA was performed within 6 hours of symptom onset, and follow-up CT was obtained within 7 days. The Spot sign and SSS were determined according to the criteria of Delgado Almandoz et al. [4]. Results: In predicting HE, the Spot sign demonstrated a sensitivity (Se) of 68.75% and a specificity (Sp) of 71.43%. The maximum transverse diameter of the Spot sign yielded an AUC of 0.699 (p = 0.021), while the SSS achieved an AUC of 0.708 (p = 0.016). In multivariate regression analysis, admission Glasgow Coma Scale (GCS), NIHSS score, Spot sign, and SSS were identified as independent predictors of HE. Conclusion: Admission GCS (OR = 0.283; p = 0.007), NIHSS score (OR = 0.760; p = 0.019), Spot sign (Se = 68.75%; Sp = 71.43%; OR = 3.00; p = 0.047), and SSS (AUC = 0.708; OR = 8.743; p = 0.009) were all independent predictors of HE, with SSS being the strongest predictor.
Keywords
Primary intracerebral hemorrhage, Spot sign, Spot sign score, Hematoma expansion
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References
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