Contrast Extravasation on Computed Tomography Angiography as a Predictor of Hematoma Expansion and Outcomes in Spontaneous Intracerebral Hemorrhage: A Retrospective Study

Contrast extravasation on CTA was present in nearly one-third of patients with spontaneous ICH in this Saudi multicenter cohort and independently predicted hematoma expansion and unfavorable outcomes. Larger hematoma volume, elevated SBP, and anticoagulant therapy were the strongest predictors. Routine assessment for the spot sign during acute ICH imaging may enhance early risk stratification and guide targeted management strategies.