Ultra-early computed tomography markers of haematoma expansion: Potential trial targets?
Among 246 patients, the swirl sign (74.3%) was the most frequent CT marker and the blend sign least frequent (7.3%). All markers were associated with increased baseline haematoma volume, and excluding the black hole sign, all were more common in patients with 24-h HE. The blend and spot signs were associated with 24-h HE and heterogenous density, swirl sign, hypodensity and island sign were associated with poor 90-day function outcomes in univariate logistic regression. However, the area under the receiver-operating-characteristic curve was similar for all markers and indicated low discriminative ability (Chi-squared test <i>p</i> = 0.81). A potential benefit of tranexamic acid in HE reduction was observed in patients with the spot sign (interaction <i>p</i> = 0.01)Conclusions:The discriminative utility of CT markers of HE in the early timeframe appears insufficient. There may be an effect of tranexamic acid in spot sign positive patients <2 h from onset.
Authors
- Sameer Sharma (ORCID: https://orcid.org/0000-0002-2415-4333)
- Chloe A. Mutimer (ORCID: https://orcid.org/0000-0001-9143-5760)
- Leonid P. Churilov (ORCID: https://orcid.org/0000-0002-9807-6606)
- Nawaf Yassi (ORCID: https://orcid.org/0000-0002-0685-0060)
- Henry Zhao (ORCID: https://orcid.org/0000-0002-4320-4287)
- Timothy John Kleinig (ORCID: https://orcid.org/0000-0003-4430-3276)
- Geoffrey Alan Donnan (ORCID: https://orcid.org/0000-0001-6324-3403)
- Jiann‐Shing Jeng (ORCID: https://orcid.org/0000-0002-1456-3686)
- Huy‐Thang Nguyen
- Stephen M. Davis (ORCID: https://orcid.org/0000-0003-0962-2300)
- Philip Choi (ORCID: https://orcid.org/0000-0003-0339-3439)
- Andrew Cheung (ORCID: https://orcid.org/0000-0003-2815-9198)
- Henry Ma (ORCID: https://orcid.org/0000-0002-0510-8059)
- Ton Duy Mai (ORCID: https://orcid.org/0000-0002-7210-3522)
- Atte Meretoja (ORCID: https://orcid.org/0000-0001-6433-1931)
- Bruce C.V. Campbell (ORCID: https://orcid.org/0000-0003-3632-9433)
- Teddy Y. Wu (ORCID: https://orcid.org/0000-0003-1845-1769)
- Gagan Sharma (ORCID: https://orcid.org/0009-0009-3427-0897)
Institutions
- Royal Adelaide Hospital (AU)
- The Royal Melbourne Hospital (AU)
- Box Hill Hospital (AU)
- The University of Melbourne (AU)
- Hanoi Medical University (VN)
- Walter and Eliza Hall Institute of Medical Research (AU)
- Helsinki University Hospital (FI)
- Liverpool Hospital (AU)
- The Alfred Hospital (AU)
- Christchurch Hospital (NZ)
- Eastern Health (AU)
- National Taiwan University Hospital (TW)
- Bạch Mai Hospital (VN)
- Hanoi Medical University Hospital (VN)
- Pham Ngoc Thach Hospital (VN)
- Monash University (AU)
- University of Otago (NZ)
Publication Details
- Journal
- European Stroke Journal
- Published
- 2025-07-12
- DOI
- https://doi.org/10.1177/23969873251355938
- Citations
- 3
- Primary Topic
- Intracerebral and Subarachnoid Hemorrhage Research
- Type
- article
- Field-Weighted Citation Impact
- 4.17