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August 2017

Can the Spot Sign Identify Who Benefits From Aggressive Blood Pressure Reduction in Intracerebral Hemorrhage?

Author Affiliations
  • 1Department of Neurology, University of Virginia Health System, Charlottesville
  • 2Department of Public Health Sciences, University of Virginia Health System, Charlottesville
JAMA Neurol. 2017;74(8):905-907. doi:10.1001/jamaneurol.2017.1022

Intracerebral hemorrhage (ICH) represents approximately 10% to 15% of strokes and results in high mortality and severe disability in those who survive the event. Hypertension is the most prevalent among many risk factors for nontraumatic ICH. In prior retrospective and prospective studies,1 the spot sign seen on computed tomographic angiography (CTA) performed in the acute setting indicated active bleeding and early hematoma expansion. In addition, studies2,3 have demonstrated a strong correlation between the initial ICH volume and worse clinical outcomes, particularly with participants who have a positive spot sign on CTA.