Haematoma expansion: imaging signs
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Haematoma expansion: imaging signs. This is seen on computed tomography angiogram (CTA). Fully referenced neurology checklist.
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
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The Island sign
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The Blend sign
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The Leakage sign
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The Satellite sign
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The Black Hole sign
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References
- Bermajo PG, Garcia JA, Perez-Fernandez S, Arenillas JF. Spot sign and live-imaged dramatic intracerebral hematoma expansion. Neurology 2010; 75:834.
- Wada R, Aviv RI, Fox AJ, et al. CT angiography "spot sign"predicts hematoma expansion in acute intracerebral hemorrhage. Stroke 2007; 38:1257-1262.
- 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.
- Kone G, Kvantaliani N, Cucchiara B. Spot sign in hemorrhagic transformation of ischemic stroke. Ann Neurol 2024; 96:591-592.
- Wagemans BA, Klinkenberg S, Postma AA. Teaching NeuroImages: Swirl sign and spot sign in intraparenchymal hematoma. Neurology 2016; 87:e225-e226.
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