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Title of Journal: Neurocrit Care

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Abbravation: Neurocritical Care

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Springer US

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DOI

10.1016/0169-5347(91)90071-5

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ISSN

1556-0961

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CT Angiography Spot Sign Hematoma Expansion and

Authors: Andrea Morotti Michael J Jessel H Bart Brouwers Guido J Falcone Kristin Schwab Alison M Ayres Anastasia Vashkevich Christopher D Anderson Anand Viswanathan Steven M Greenberg M Edip Gurol Javier M Romero Jonathan Rosand Joshua N Goldstein
Publish Date: 2016/01/12
Volume: 25, Issue: 1, Pages: 79-85
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Abstract

The computed tomography angiography CTA spot sign is a validated predictor of hematoma expansion and poor outcome in supratentorial intracerebral hemorrhage ICH but patients with brainstem ICH have typically been excluded from the analyses We investigated the frequency of spot sign and its relationship with hematoma expansion and outcome in patients with primary pontine hemorrhage PPHWe performed a retrospective analysis of PPH cases obtained from a prospectively collected cohort of consecutive ICH patients who underwent CTA CTA firstpass readings for spot sign presence were analyzed by two trained readers Baseline and followup hematoma volumes on noncontrast CT scans were assessed by semiautomated computerassisted volumetric analysis Sensitivity specificity positive predictive value PPV negative predictive value NPV positive and negative likelihood ratio and accuracy of spot sign for prediction of inhospital mortality were calculated49 subjects met the inclusion criteria of whom 11 224  showed a spot sign Inhospital mortality was higher in spot signpositive versus spot signnegative subjects 909 vs 474  p = 0020 Spot sign showed excellent specificity 95  and PPV 91  in predicting inhospital mortality Absolute hematoma growth defined as parenchymal and intraventricular hematoma expansion of any amount was significantly higher in spot signpositive versus spot signnegative subjects 1372 ± 2093 vs 376 ± 855 mL p = 0045This study was supported by the following awards from the NINDS 5R01NS073344 K23AG02872605 K23 NS086873 R01NS059727 None of the funding entities had any involvement in study design data collection analysis and interpretation writing of the manuscript or decision to submit the study for publicationAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards


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  1. Ondine’s Curse with Accompanying Trigeminal and Glossopharyngeal Neuralgia Secondary to Medullary Telangiectasia
  2. Anti-Adrenergic Medications and Edema Development after Intracerebral Hemorrhage
  3. Critical Care Guidelines on the Endovascular Management of Cerebral Vasospasm
  4. Prompt Recognition and Management of Postoperative Intracranial Hypotension-Associated Venous Congestion: A Case Report
  5. The Effect of Decompressive Hemicraniectomy on Brain Temperature After Severe Brain Injury
  6. High Dose Deferoxamine in Intracerebral Hemorrhage (H i -D ef ) Trial: Rationale, Design, and Methods
  7. Therapeutic Temperature Modulation for Fever After Intracerebral Hemorrhage
  8. Aggressive Care After a Massive Stroke in Young Patients: Is That What They Want?
  9. Research and Technology in Neurocritical Care
  10. Modeling the Pattern of Contrast Extravasation in Acute Intracerebral Hemorrhage Using Dynamic Contrast-Enhanced MR
  11. Biomarkers Improve Clinical Outcome Predictors of Mortality Following Non-Penetrating Severe Traumatic Brain Injury
  12. Long-Term Outcome Call into Question the Benefit of Positive Fluid Balance and Colloid Treatment After Aneurysmal Subarachnoid Hemorrhage
  13. 1 H-MR Spectroscopy in Traumatic Brain Injury
  14. Emergency Neurological Life Support: Status Epilepticus
  15. Ventilation Practices in Subarachnoid Hemorrhage: A Cohort Study Exploring the Use of Lung Protective Ventilation
  16. Levetiracetam is Associated with Improved Cognitive Outcome for Patients with Intracranial Hemorrhage
  17. Systemic Administration of LPS Worsens Delayed Deterioration Associated with Vasospasm After Subarachnoid Hemorrhage Through a Myeloid Cell-Dependent Mechanism
  18. Treatment of Elevated Intracranial Pressure with Hyperosmolar Therapy in Patients with Renal Failure
  19. Therapeutic Hypothermia for Adult Viral Meningoencephalitis
  20. Effects of Red Blood Cell Transfusion on Long-Term Disability of Patients with Traumatic Brain Injury
  21. Emergency Neurological Life Support: Approach to the Patient with Coma
  22. Macroglossia Associated with Brainstem Injury
  23. Head Computed Tomography Scanning During Pediatric Neurocritical Care: Diagnostic Yield and the Utility of Portable Studies
  24. Monitoring of Hematological and Hemostatic Parameters in Neurocritical Care Patients
  25. The Effect of Increased Inspired Fraction of Oxygen on Brain Tissue Oxygen Tension in Children with Severe Traumatic Brain Injury

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