Abstract
Objective: To determine the prevalence of hematoma expansion and identify imaging factors associated with hematoma expansion in patients with primary supratentorial intracerebral hemorrhage admitted within 24 hours of symptom onset. Methods: This observational descriptive study included 204 patients with primary supratentorial intracerebral hemorrhage who were admitted within 24 hours after symptom onset and treated at the Stroke Center, Bach Mai Hospital. Clinical and imaging characteristics were collected and analyzed. Logistic regression analysis was performed to identify imaging factors independently associated with hematoma expansion. Results: A total of 204 patients were enrolled, of whom 25 (12.3%) experienced hematoma expansion. Compared with patients without hematoma expansion, those with hematoma expansion had a larger baseline hematoma volume, a shorter time from symptom onset to the initial computed tomography (CT) scan, greater midline shift, and a higher prevalence of intraventricular hemorrhage (all p < 0.05). Multivariable logistic regression analysis demonstrated that the Spot sign (adjusted odds ratio [aOR] = 10.06; 95% confidence interval [CI]: 2.54–39.77; p = 0.001) and the Satellite sign (aOR = 25.89; 95% CI: 5.40–124.13; p < 0.001) were independently associated with hematoma expansion. Conclusions: Hematoma expansion occurred in 12.3% of patients with primary supratentorial intracerebral hemorrhage. The Spot sign and Satellite sign were independently associated with hematoma expansion and may be useful for early risk stratification and for guiding treatment and intensive monitoring strategies. However, larger studies are warranted to further validate the prognostic value of these imaging markers.
