Vascular and nonvascular mimics of the CT angiography "spot sign" in patients with secondary intracerebral hemorrhage.

Abstract:

BACKGROUND AND PURPOSE:The newly-described computed tomography angiography (CTA) Spot Sign is present in about one third of patients with acute primary intracerebral hemorrhage (PICH) and predicts hematoma expansion. This sign has not been systematically evaluated in patients with secondary causes of ICH, and mimics have not been characterized. The purpose of this study was to assess for the presence of the Spot Sign in secondary ICH and to document potential mimics of the Spot Sign and their distinguishing features. METHODS:We performed a retrospective chart review of consecutive patients presenting with ICH to our regional stroke center between January 2002 and May 2007. Ninety-six ICH patients underwent a CT stroke protocol including CTA. CTA documented a secondary cause for hemorrhage in 30 patients (31%). Each patient was assessed for the presence or absence of the CTA Spot Sign or a mimic by 2 blinded neuroradiologists. Clinical and radiological features of PICH and secondary ICH were compared. RESULTS:No patients with secondary ICH had a true CTA Spot Sign, but several Spot Sign mimics were identified including: micro AVM, posterior communicating artery aneurysm, Moya Moya, and neoplasm-associated calcification. The secondary ICH group was younger (P=0.0001) and less likely to be hypertensive at presentation (P=0.0114). Significant hematoma expansion (>33% increase from baseline volume) occurred in 20% of secondary ICH patients and 28% of PICH patients (P=0.2463). CONCLUSIONS:This study describes mimics of the CTA Spot Sign and classifies them as vascular (microAVM, aneurysm, Moya Moya) or nonvascular (tumor and choroid plexus calcification). Evaluation of the noncontrast CT together with the CTA source images is an essential part of the evaluation for the Spot Sign. Vessels entering the hematoma from the periphery are indicative of an underlying vascular lesion. Our findings suggest that the Spot Sign may be rare in secondary ICH and most specific for PICH.

journal_name

Stroke

journal_title

Stroke

authors

Gazzola S,Aviv RI,Gladstone DJ,Mallia G,Li V,Fox AJ,Symons SP

doi

10.1161/STROKEAHA.107.499442

subject

Has Abstract

pub_date

2008-04-01 00:00:00

pages

1177-83

issue

4

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.107.499442

journal_volume

39

pub_type

杂志文章

相关文献

STROKE文献大全
  • Periprocedural Myocardial Infarction After Carotid Endarterectomy and Stenting: Systematic Review and Meta-Analysis.

    abstract:BACKGROUND AND PURPOSE:Carotid angioplasty and stenting (CAS) is associated with higher risk of periprocedural stroke and death when compared with carotid endarterectomy (CEA). By contrast, the risk of myocardial infarction (MI) was higher after CEA than after CAS in randomized trials. However, numbers were small, and ...

    journal_title:Stroke

    pub_type: 杂志文章,meta分析,评审

    doi:10.1161/STROKEAHA.115.010052

    authors: Boulanger M,Camelière L,Felgueiras R,Berger L,Rerkasem K,Rothwell PM,Touzé E

    更新日期:2015-10-01 00:00:00

  • Coffee consumption and risk of stroke in women.

    abstract:BACKGROUND AND PURPOSE:Coffee consumption has been inconsistently associated with stroke incidence and mortality in previous studies. We investigated the association between coffee consumption and stroke incidence in the Swedish Mammography Cohort. METHODS:We prospectively followed of 34,670 women without a history of...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.603787

    authors: Larsson SC,Virtamo J,Wolk A

    更新日期:2011-04-01 00:00:00

  • Diffusion- and perfusion-weighted magnetic resonance imaging of the brain before and after coronary artery bypass grafting surgery.

    abstract:BACKGROUND AND PURPOSE:Coronary artery bypass grafting (CABG) is a frequently performed surgical procedure that can be associated with neurological complications. Some studies have demonstrated that new focal brain lesions, detected by MRI, can develop after CABG. Furthermore, it has been suggested that the presence of...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.str.0000040408.75704.15

    authors: Restrepo L,Wityk RJ,Grega MA,Borowicz L Jr,Barker PB,Jacobs MA,Beauchamp NJ,Hillis AE,McKhann GM

    更新日期:2002-12-01 00:00:00

  • Impaired cerebral autoregulation is associated with vasospasm and delayed cerebral ischemia in subarachnoid hemorrhage.

    abstract:BACKGROUND AND PURPOSE:Cerebral autoregulation may be impaired in the early days after subarachnoid hemorrhage (SAH). The purpose of this study was to examine the relationship between cerebral autoregulation and angiographic vasospasm (aVSP) and radiographic delayed cerebral ischemia (DCI) in patients with SAH. METHOD...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.002630

    authors: Otite F,Mink S,Tan CO,Puri A,Zamani AA,Mehregan A,Chou S,Orzell S,Purkayastha S,Du R,Sorond FA

    更新日期:2014-03-01 00:00:00

  • Predictors of good clinical outcomes, mortality, and successful revascularization in patients with acute ischemic stroke undergoing thrombectomy: pooled analysis of the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) and Multi MERCI Trials.

    abstract:BACKGROUND AND PURPOSE:The Mechanical Embolus Removal in Cerebral Ischemia (MERCI) and Multi MERCI trials evaluated the safety and efficacy of thrombectomy in the treatment of intracranial arterial occlusions within 8 hours of symptom onset. We sought to determine the predictors of clinical and angiographic outcomes in...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.109.561431

    authors: Nogueira RG,Liebeskind DS,Sung G,Duckwiler G,Smith WS,MERCI.,Multi MERCI Writing Committee.

    更新日期:2009-12-01 00:00:00

  • Risks and benefits of oral anticoagulation compared with clopidogrel plus aspirin in patients with atrial fibrillation according to stroke risk: the atrial fibrillation clopidogrel trial with irbesartan for prevention of vascular events (ACTIVE-W).

    abstract:BACKGROUND AND PURPOSE:In ACTIVE-W, oral anticoagulation (OAC) was more efficacious than combined clopidogrel plus aspirin (C+A) in preventing vascular events in patients with atrial fibrillation. However, because OAC carries important bleeding complications, risk stratification schemes have been devised to identify pa...

    journal_title:Stroke

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/STROKEAHA.107.500199

    authors: Healey JS,Hart RG,Pogue J,Pfeffer MA,Hohnloser SH,De Caterina R,Flaker G,Yusuf S,Connolly SJ

    更新日期:2008-05-01 00:00:00

  • Delayed cerebellar infarction following a car accident.

    abstract::A patient developed a cerebellar infarction five weeks after a car accident. The pathophysiology and the medico-legal implications are discussed. ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.14.4.617

    authors: Nichelli P,Gibertoni M,Guerzoni C

    更新日期:1983-07-01 00:00:00

  • Effects of fluoxetine and maprotiline on functional recovery in poststroke hemiplegic patients undergoing rehabilitation therapy.

    abstract:BACKGROUND AND PURPOSE:In animals, drugs that increase brain amine concentrations influence the rate and degree of recovery from cortical lesions. It is therefore conceivable that antidepressants may influence outcome after ischemic brain injury in humans. We evaluated the effects of the norepinephrine reuptake blocker...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.str.27.7.1211

    authors: Dam M,Tonin P,De Boni A,Pizzolato G,Casson S,Ermani M,Freo U,Piron L,Battistin L

    更新日期:1996-07-01 00:00:00

  • The layered fabric of cerebral artery fenestrations.

    abstract:BACKGROUND AND PURPOSE:Intravascular bridges, resulting from developmental anomalies of brain arteries, are now better known as arterial fenestrations. Their tendency to develop aneurysms, similar to arterial bifurcations, makes their anatomy and microstructure important for study. METHODS:Six segments of artery, each...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.25.9.1799

    authors: Finlay HM,Canham PB

    更新日期:1994-09-01 00:00:00

  • Presynaptic and postsynaptic alpha 2-adrenergic receptors in human cerebral arteries and their alteration after subarachnoid hemorrhage.

    abstract::The nature of alpha-adrenergic receptors in human cerebral arteries was characterized, and alteration of these receptors after subarachnoid hemorrhage was examined using a radioligand binding assay. Norepinephrine content of control arteries was also analyzed and compared with that of arteries after subarachnoid hemor...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.19.1.80

    authors: Tsukahara T,Taniguchi T,Miwa S,Shimohama S,Fujiwara M,Nishikawa M,Handa H

    更新日期:1988-01-01 00:00:00

  • Hypertensive encephalopathy after bilateral carotid endarterectomy.

    abstract:BACKGROUND:Hypertension occurs frequently after carotid endarterectomy and may lead to cerebral vascular complications and myocardial infarction. Its pathophysiology has recently been related to surgically induced damage of carotid baroreceptors. CASE DESCRIPTION:A 45-year-old normotensive man with no history of epile...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.3.488

    authors: Ille O,Woimant F,Pruna A,Corabianu O,Idatte JM,Haguenau M

    更新日期:1995-03-01 00:00:00

  • Magnetic resonance and clinical cerebrovascular disease. An update.

    abstract::MRI is becoming the imaging modality of choice in patients with ischemic cerebrovascular disease although CT is still the test of choice to exclude acute hemorrhagic stroke. We have briefly reviewed characteristic features of ischemic and hemorrhagic cerebrovascular disease as well as vascular anomalies as seen on MRI...

    journal_title:Stroke

    pub_type: 杂志文章,评审

    doi:10.1161/01.str.20.9.1279

    authors: Ramadan NM,Deveshwar R,Levine SR

    更新日期:1989-09-01 00:00:00

  • Hypertensive putaminal hemorrhage: treatment and results. Is surgical treatment superior to conservative one?

    abstract::Seventy-four patients with hypertensive putaminal hemorrhage (HPH) were followed at least 6 months after treatment and estimated by ADL. They were graded according to the state of consciousness on admission. The grading consists of 6 grades: Grade 1, fully conscious; Grade 2, somnolent; Grade 3, stuporous; Grade 4, se...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.14.4.480

    authors: Waga S,Yamamoto Y

    更新日期:1983-07-01 00:00:00

  • Enlarged perivascular spaces on MRI are a feature of cerebral small vessel disease.

    abstract:BACKGROUND AND PURPOSE:Enlarged perivascular spaces in the brain are common but generally overlooked and of uncertain pathophysiology. They may reflect underlying cerebral small vessel disease. We determined whether enlarged perivascular spaces were associated with lacunar stroke subtype and white matter hyperintensiti...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.109.564914

    authors: Doubal FN,MacLullich AM,Ferguson KJ,Dennis MS,Wardlaw JM

    更新日期:2010-03-01 00:00:00

  • Hypercortisolism revealed by the dexamethasone suppression test in patients [corrected] with acute ischemic stroke.

    abstract::Using the dexamethasone suppression test, we studied the activity of the hypothalamic-pituitary-adrenal axis within the first week after onset in 62 patients with acute ischemic stroke. Compared with two control groups (one comprising 25 elderly patients with various acute medical disorders and the other comprising 33...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.20.12.1685

    authors: Olsson T,Aström M,Eriksson S,Forssell A

    更新日期:1989-12-01 00:00:00

  • Predictors of rehemorrhage after treatment of ruptured intracranial aneurysms: the Cerebral Aneurysm Rerupture After Treatment (CARAT) study.

    abstract:BACKGROUND AND PURPOSE:The primary purpose of intracranial aneurysm treatment is to prevent rupture. Risk factors for rupture after aneurysm treatment have not been clearly established, and the need to completely occlude aneurysms is debated. METHODS:The Cerebral Aneurysm Rerupture After Treatment (CARAT) study is an ...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究

    doi:10.1161/STROKEAHA.107.495747

    authors: Johnston SC,Dowd CF,Higashida RT,Lawton MT,Duckwiler GR,Gress DR,CARAT Investigators.

    更新日期:2008-01-01 00:00:00

  • Influence of age on outcome from thrombolysis in acute stroke: a controlled comparison in patients from the Virtual International Stroke Trials Archive (VISTA).

    abstract:BACKGROUND AND PURPOSE:Thrombolysis for acute ischemic stroke in patients aged > 80 years is not approved in some countries due to limited trial data in the very elderly. We compared outcomes between thrombolysed and nonthrombolysed (control) patients from neuroprotection trials to assess any influence of age on respon...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.586206

    authors: Mishra NK,Diener HC,Lyden PD,Bluhmki E,Lees KR,VISTA Collaborators.

    更新日期:2010-12-01 00:00:00

  • Treatment of hyperglycemia in ischemic stroke (THIS): a randomized pilot trial.

    abstract:BACKGROUND AND PURPOSE:Hyperglycemia may worsen brain injury during acute cerebral infarction. We tested the feasibility and tolerability of aggressive hyperglycemia correction with intravenous insulin compared with usual care during acute cerebral infarction. METHODS:We conducted a randomized, multicenter, blinded pi...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/STROKEAHA.107.493544

    authors: Bruno A,Kent TA,Coull BM,Shankar RR,Saha C,Becker KJ,Kissela BM,Williams LS

    更新日期:2008-02-01 00:00:00

  • Endothelial function and carotid intima-media thickness in young healthy subjects among endothelial nitric oxide synthase Glu298-->Asp and T-786-->C polymorphisms.

    abstract:BACKGROUND AND PURPOSE:To assess the role of the endothelial nitric oxide synthase (eNOS) gene variants as risk factors for early atherosclerosis, we sought to investigate whether two polymorphisms located in the exon 7 (Glu298-->Asp) and in the promoter region (T-786-->C) of the eNOS gene were associated with function...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000126482.86708.37

    authors: Paradossi U,Ciofini E,Clerico A,Botto N,Biagini A,Colombo MG

    更新日期:2004-06-01 00:00:00

  • Ischemic brain damage is not ameliorated by 1,3-butanediol in hyperglycemic rats.

    abstract:BACKGROUND AND PURPOSE:Treatment with the ketone body precursor 1,3-butanediol has been suggested to ameliorate hypoxic/ischemic brain damage. Butanediol could provide an alternative energy substrate for the brain, thereby decreasing the amount of glycolytically produced lactate. Hyperglycemia aggravates brain damage a...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.23.5.719

    authors: Lundgren J,Smith ML,Mans AM,Siesjö BK

    更新日期:1992-05-01 00:00:00

  • Risk of recurrent subarachnoid hemorrhage after complete obliteration of cerebral aneurysms.

    abstract:BACKGROUND AND PURPOSE:The neck clipping of cerebral aneurysms is a well-established treatment for subarachnoid hemorrhage (SAH) caused by aneurysmal rupture. However, it is still unclear how great a risk of recurrence patients with a successfully treated aneurysm carry over a long-term period. METHODS:Of 425 patients...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.29.12.2511

    authors: Tsutsumi K,Ueki K,Usui M,Kwak S,Kirino T

    更新日期:1998-12-01 00:00:00

  • Effects of a selective CD11b/CD18 antagonist and recombinant human tissue plasminogen activator treatment alone and in combination in a rat embolic model of stroke.

    abstract:BACKGROUND AND PURPOSE:We evaluated the neuroprotective effect of UK-279,276 (also referred to as recombinant neutrophil inhibitory factor), a selective CD11b/CD18 antagonist, in combination with thrombolytic therapy on focal cerebral ischemia. METHODS:Male Wistar rats (n=88) were subjected to embolic middle cerebral ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000077016.55891.2E

    authors: Zhang L,Zhang ZG,Zhang RL,Lu M,Krams M,Chopp M

    更新日期:2003-07-01 00:00:00

  • Immunohistochemical characterization of the amyloid deposits and quantitation of pertinent cerebrospinal fluid proteins in hereditary cerebral hemorrhage with amyloidosis.

    abstract::Cystatin C, a protein inhibitor of lysosomal cysteine proteinases, was demonstrated by immunohistochemical techniques to be present in the birefringent amyloid deposits of the small arteries in the cerebrum, cerebellum, and leptomeninges of 10 Icelandic individuals with hereditary cerebral hemorrhage with amyloidosis....

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.18.2.431

    authors: Löfberg H,Grubb AO,Nilsson EK,Jensson O,Gudmundsson G,Blöndal H,Arnason A,Thorsteinsson L

    更新日期:1987-03-01 00:00:00

  • Is there a direct link between cerebrovascular activity and cerebrospinal fluid pressure-volume compensation?

    abstract:BACKGROUND AND PURPOSE:Cerebral blood flow is coupled to brain metabolism by means of active modulation of cerebrovascular resistance. This homeostatic vasogenic activity is reflected in slow waves of cerebral blood flow velocities (FV) which can also be detected in intracranial pressure (ICP). However, effects of incr...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.485847

    authors: Haubrich C,Czosnyka Z,Lavinio A,Smielewski P,Diehl RR,Pickard JD,Czosnyka M

    更新日期:2007-10-01 00:00:00

  • Dietary potassium intake and risk of stroke: a dose-response meta-analysis of prospective studies.

    abstract:BACKGROUND AND PURPOSE:Potassium intake has been inconsistently associated with risk of stroke. Our aim was to conduct a meta-analysis of prospective studies to assess the relation between potassium intake and stroke risk. METHODS:Pertinent studies were identified by a search of PubMed from January 1966 through March ...

    journal_title:Stroke

    pub_type: 杂志文章,meta分析

    doi:10.1161/STROKEAHA.111.622142

    authors: Larsson SC,Orsini N,Wolk A

    更新日期:2011-10-01 00:00:00

  • Ischemic stroke during sleep: its association with worse early functional outcome.

    abstract:BACKGROUND AND PURPOSE:Approximately one fourth of stroke occur during sleep. Despite the clinical and radiological similarities between wake-up stroke (WUS) and non-WUS, the functional outcomes of WUS are largely unknown. METHODS:This retrospective analysis reviewed 2289 consecutive patients with acute ischemic strok...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.602243

    authors: Kim BJ,Lee SH,Shin CW,Ryu WS,Kim CK,Yoon BW

    更新日期:2011-07-01 00:00:00

  • Detection of carotid stenosis. From NASCET results to clinical practice.

    abstract:BACKGROUND AND PURPOSE:Results from large multicenter studies have shown that carotid endarterectomy, performed with low perioperative morbidity and mortality, is beneficial for patients with symptomatic carotid stenosis > or = 70% as calculated according to strict angiographic criteria. To apply these results in clini...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.8.1325

    authors: Chang YJ,Golby AJ,Albers GW

    更新日期:1995-08-01 00:00:00

  • Chronic cerebral blood flow changes following experimental subarachnoid hemorrhage in rats.

    abstract::Experimental subarachnoid hemorrhage was induced in 52 adult male Wistar rats by microsurgical transclival basilar artery puncture. Telencephalic blood flow measured in 24 rats with subarachnoid hemorrhage was compared with that in 23 sham-operated rats and 10 unoperated control rats using the [14C]butanol indicator f...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.21.4.577

    authors: Kader A,Krauss WE,Onesti ST,Elliott JP,Solomon RA

    更新日期:1990-04-01 00:00:00

  • Right-left propensity and lesion patterns between cardiogenic and aortogenic cerebral embolisms.

    abstract:BACKGROUND AND PURPOSE:Based on thrombus location and nature and anatomic features of aorta and cerebral arteries, we hypothesized that cardiogenic embolisms (CE) and aortogenic embolisms (AE) might have different right-left propensity and lesion patterns. METHODS:We retrospectively reviewed patients with acute ischem...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.111.616573

    authors: Kim HJ,Song JM,Kwon SU,Kim BJ,Kang DH,Song JK,Kim JS,Kang DW

    更新日期:2011-08-01 00:00:00

  • Effect of carotid endarterectomy on patterns of cerebrovascular reactivity in patients with unilateral carotid artery stenosis.

    abstract:BACKGROUND AND PURPOSE:Patients with unilateral significant carotid artery stenosis present with a variable intracranial hemodynamic status. In the majority of patients, hemodynamics are normal because of sufficient collateral flow. One subgroup shows poor ipsilateral hemodynamics because of a severely reduced blood su...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.25.10.1952

    authors: Hartl WH,Janssen I,Fürst H

    更新日期:1994-10-01 00:00:00