Haematoma expansion: imaging signs

Evidence-based neurology checklist on haematoma expansion: imaging signs: The Spot sign This is seen on computed tomography angiogram (CTA) It is a 1-2mm enhancement within the hematoma It is caused by contrast extravasation into the haematoma It predicts hematoma expansion even in delayed…

The Spot sign

  • This is seen on computed tomography angiogram (CTA)
  • It is a 1-2mm enhancement within the hematoma
  • It is caused by contrast extravasation into the haematoma
  • It predicts hematoma expansion even in delayed presentations
  • It may also be seen in haemorrhagic transformation of ischaemic stroke

The Swirl sign

The Island sign

The Blend sign

The Leakage sign

The Satellite sign

The Black Hole sign

References

  1. Bermajo PG, Garcia JA, Perez-Fernandez S, Arenillas JF. Spot sign and live-imaged dramatic intracerebral hematoma expansion. Neurology 2010; 75:834.
  2. Wada R, Aviv RI, Fox AJ, et al. CT angiography "spot sign"predicts hematoma expansion in acute intracerebral hemorrhage. Stroke 2007; 38:1257-1262.
  3. Brouwers HB, Falcone GJ, Kristen A, et al. CTA spot sign predicts hematoma expansion in patients with delayed presentation after intracerebral hemorrhage. Neurocrit Care 2012; 17:421-428.
  4. Kone G, Kvantaliani N, Cucchiara B. Spot sign in hemorrhagic transformation of ischemic stroke. Ann Neurol 2024; 96:591-592.
  5. Wagemans BA, Klinkenberg S, Postma AA. Teaching NeuroImages: Swirl sign and spot sign in intraparenchymal hematoma. Neurology 2016; 87:e225-e226.
  6. And 8 more. Subscribe to see the full list

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