Atormac
briv
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 10907  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 Search
 
  
 Resource Links
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (738 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this Article
   References
   Article Figures

 Article Access Statistics
    Viewed492    
    Printed2    
    Emailed0    
    PDF Downloaded14    
    Comments [Add]    

Recommend this journal

 


 
Table of Contents    
NEUROIMAGE
Year : 2021  |  Volume : 69  |  Issue : 4  |  Page : 1119-1120

CT “Spot” and “Leakage” Signs Predicting Intracerebral Hematoma Expansion


Department of Neurology, Aster Medcity, Kochi, Kerala, India

Date of Submission08-Aug-2018
Date of Decision14-Dec-2019
Date of Acceptance20-Jan-2020
Date of Web Publication2-Sep-2021

Correspondence Address:
Boby V Maramattom
Department of Neurology, Aster Medcity, Kochi - 682 023, Kerala
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.325367

Rights and Permissions



How to cite this article:
Mathews DJ, Ram S A, Maramattom BV. CT “Spot” and “Leakage” Signs Predicting Intracerebral Hematoma Expansion. Neurol India 2021;69:1119-20

How to cite this URL:
Mathews DJ, Ram S A, Maramattom BV. CT “Spot” and “Leakage” Signs Predicting Intracerebral Hematoma Expansion. Neurol India [serial online] 2021 [cited 2021 Dec 5];69:1119-20. Available from: https://www.neurologyindia.com/text.asp?2021/69/4/1119/325367




A 56-year-old male patient presented with acute onset left hemiplegia of 1 h duration. He was on aspirin 75 mg daily for a coronary bypass surgery 5 years ago. A plain CT followed by CT angiogram (CTA) and delayed phase CTA at 3 and 5 min showed a spot sign and leakage signs, suggestive of an expanding hematoma [Figure 1]. At 2 h, his sensorium deteriorated further and a repeat CT scan showed a massive increase in the intracerebral bleed. He was taken up for decompressive craniectomy but remained comatose after surgery. Combining plain CT with CTA and delayed phase CTA sequences may demonstrate a “spot sign” or a “leakage sign” and increase the sensitivity of prediction of intracerebral hemorrhage expansion.[1],[2]
Figure 1: (a) Initial plain CT shows a 12 ml right basal ganglia ICH. (b) Initial CTA images show the “spot sign.” (c) Delayed phase CTA at 3 min shows contrast extravasation. (d) Delayed phase CTA at 5 min shows further contrast extravasation (“Leakage sign”). (e) Final plain CT at 2 h shows a 7-fold expanded ICH of 83 ml volume

Click here to view


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Orito K, Hirohata M, Nakamura Y, Takeshige N, Aoki T, Hattori G, et al. Leakage sign for primary intracerebral hemorrhage: A novel predictor of hematoma growth. Stroke 2016;47:958-63.  Back to cited text no. 1
    
2.
Chakraborty S, Alhazzaa M, Wasserman JK, Sun YY, Stotts G, Hogan MJ, et al. Dynamic characterization of the CT angiographic 'spot sign'. PLoS One 2014;9:e90431.  Back to cited text no. 2
    


    Figures

  [Figure 1]



 

Top
Print this article  Email this article
   
Online since 20th March '04
Published by Wolters Kluwer - Medknow