| Contrast extravasation on CT angiography predicts hematoma expansion in intracerebral hemorrhage. | |
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MedLine Citation:
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PMID: 17372123 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Patients with acute intracerebral hemorrhage (ICH) presenting within 3 hours of symptom onset are known to be at increased risk of expansion. However, only a minority arrive within this time frame. Therefore, alternative markers for expansion risk are needed. OBJECTIVE: To examine whether contrast extravasation on CT angiography (CTA) at presentation predicts subsequent hematoma expansion. METHODS: Consecutive patients with primary ICH presenting to an urban tertiary care hospital were prospectively captured in a database. We retrospectively reviewed images for all patients receiving a CTA and at least one further CT scan within 48 hours. RESULTS: Complete data were available for 104 patients. Contrast extravasation at the time of CTA was present in 56% of patients, and associated with an increased risk of hematoma expansion (22% vs 2%, p = 0.003). Patients who received a baseline CTA within 3 hours were more likely to have subsequent expansion (27%, vs 13% for those presenting later, p = 0.1). However, after multivariable analysis, contrast extravasation was the only significant predictor of hematoma expansion (OR 18, 95% CI 2.1 to 162). This effect was independent of time to presentation. CONCLUSIONS: Contrast extravasation is independently associated with hematoma expansion. Patients presenting within the first few hours after symptom onset have traditionally been considered those at highest risk of expansion. However, for those presenting later, the presence of contrast may be a useful marker to guide therapies aimed at decreasing this risk. |
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Authors:
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J N Goldstein; L E Fazen; R Snider; K Schwab; S M Greenberg; E E Smith; M H Lev; J Rosand |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Neurology Volume: 68 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-03-20 Completed Date: 2007-04-16 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 889-94 Citation Subset: AIM; IM |
Affiliation:
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Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA. jgoldstein@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Cerebral Angiography / methods* Cerebral Arteries / pathology, physiopathology* Cerebral Cortex / blood supply, physiopathology, radiography Cerebral Hemorrhage / pathology, physiopathology, radiography* Cohort Studies Contrast Media / pharmacokinetics Disease Progression Early Diagnosis Extravasation of Diagnostic and Therapeutic Materials / physiopathology, radiography* Female Hematoma / pathology, physiopathology, radiography* Humans Male Middle Aged Predictive Value of Tests Prognosis Prospective Studies Tomography, X-Ray Computed / methods* |
| Grant Support | |
ID/Acronym/Agency:
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1 K23 NS42695-01/NS/NINDS NIH HHS; R01 NS04217/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media |
| Comments/Corrections | |
Comment In:
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Neurology. 2007 Aug 7;69(6):617; author reply 617
[PMID:
17679688
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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