Article Figures & Data
Figures
- FIG 1.
NCCT hematoma EMs. A, Blend sign: a relatively hypoattenuating area next to a hyperattenuating area of the hematoma, with a well-defined margin and a density difference of >18 HU between the 2 areas. B, Island sign: at least 3 scattered small hematomas all separate from the main hematoma (black arrows) or at least 4 small hematomas, some or all of which may connect with the main hematoma (dashed arrows), all visible on a single axial section. The white arrow identifies both a hypodensity (any hypodense region strictly encapsulated within the hemorrhage with any shape, size, and density) and a swirl sign (rounded, streak-like, or irregular region of hypo- or isoattenuation compared with the brain parenchyma that does not have to be encapsulated in the hematoma). C, Satellite sign: a small hematoma (diameter of <10 mm) separate from the main hemorrhage in at least 1 section and distinct from the main hematoma by a 1- to 20- mm separation (black arrows). D, Black hole sign: a hypoattenuating area with a density difference of >28 HU compared with the surrounding hematoma, which has no connection with the surface outside the hematoma (black arrow). This finding also corresponds to a hypodensity and a swirl sign. For the 2 hypodense foci labeled with white arrows, because the density difference with the hyperattenuating hematoma is <28 HU, they cannot be considered black hole signs. E, Fluid level: presence of 1 distinct hypoattenuating area (hypodense to the brain) above 1 hyperattenuating area (hyperdense to the brain), below a discrete straight line of separation (dashed line), irrespective of its density appearance. F, Barras density and shape signs are evaluated on the axial section showing the largest hematoma area and are based on a 5-point scale. Density is considered heterogeneous when there are ≥3 hypodensity foci within the hyperdense hematoma (scale of III, IV, or V). Shape is considered irregular when there are ≥2 focal hematoma margin irregularities, joined or separate from the hematoma edge (scale of III, IV, or V). Definitions from Morotti et al.4
- FIG 2.
Flowchart.
- FIG 3.
Sensitivity and specificity of NCCT expansion markers for rHE.
- FIG 4.
Sensitivity and specificity of expansion marker count for rHE.
Tables
Association of EMs with rHEa
EM Unadjusted Adjustedb OR (95% CI) P Value OR (95% CI) P Value Barras density 1.96 (0.95–4.08) .07 1.11 (0.46–2.66) .81 Black hole 8.66 (2.15–58.14) .007c 5.62 (1.23–40.23) .03c Blend 2.90 (1.08–8.38) .04c 1.45 (0.43–4.99) .55 Fluid level 0.38 (0.06–1.67) .25 0.35 (0.05–1.60) .18 Hypodensity 3.18 (1.49–6.93) .003c 2.01 (0.77–5.31) .15 Swirl 1.91 (0.87–4.37) .12 1.20 (0.48–3.05) .70 Barras shape 2.41 (1.17–5.10) .02c 1.48 (0.63–3.51) .37 Island 1.37 (0.53–3.55) .51 0.49 (0.12–1.72) .27 Satellite 2.84 (1.29–6.61) .01c 1.73 (0.68–4.57) .25 Combined EMs Any shape marker 2.90 (1.26–7.18) .02c 1.87 (0.69–5.38) .22 Any density marker 1.76 (0.74–4.44) .21 0.93 (0.34–2.68) .90 Shape marker count 1.57 (1.11–2.27) .01c 1.17 (0.73–1.87) .51 Density marker count 1.51 (1.16–1.99) .003c 1.27 (0.87–1.86) .21 Any EM 2.38 (0.85–7.75) .12 1.33 (0.41–4.87) .64 EM count 1.33 (1.12–1.60) .002c 1.20 (0.91–1.58) .20 Expansion-prone hematoma 2.50 (1.16–5.50) .02c 1.30 (0.45–3.69) .63 ↵a Revised hematoma expansion was defined as any of a ≥ 6-mL or ≥33% increase in ICH volume, a ≥ 1-mL increase in intraventricular hemorrhage volume, or de novo intraventricular hemorrhage.
↵b Adjusted for antiplatelet use, anticoagulant use, baseline ICH volume, and last-seen-well to initial CT.
↵c P < .05.
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