London, United Kingdom 2013 Cerebrovasc Dis 2013; 35 (suppl 3)1-854 127 10:30-12:30 Oral Session Room 17 Intracerebral/subarachnoid haemorrhage and venous diseases Chairs: C. Stapf, France and D. Werring, UK 1 Intracerebral/subarachnoid haemorrhage and venous diseases 10:30 - 10:40 Time Course of Active Post-admission Intracerebral Hematoma Expansion C. Ovesen1, A.F. Christensen2, D. Krieger3, S. Rosenbaum4, H. Christensen5 Department of Neurology, Bispebjerg University Hospital, Copenhagen, DENMARK1,De-partment of Radiology, Bispebjerg University Hospital, Copenhagen, DENMARK2, Depart-ment of Neurology, Bispebjerg University Hospital, Copenhagen, DENMARK3, Department of Neurology, Bispebjerg University Hospital, Copenhagen, DENMARK4, Department of Neurol-ogy, Bispebjerg University Hospital, Copenhagen, DENMARK5 Background: The time course of active hematoma expansion after acute hospital admission in patients with intracerebral hematoma (ICH) has remained unknown mainly because techniques capable of serial ICH volume assessments are challenging. We aimed at determining the temporal profile of ICH expansion after hospital admission by using transcranial B-mode ultrasound (TCUS). Method: Consecutive patients presenting with spontaneous ICH within 4.5 hours after symptom onset from September 2011 until December 2012 were assessed. On admission, patients underwent non-contrast CT and CT-angiography (CTA) followed by serial hematoma volume monitoring using TCUS: every 30 minutes during the first 6 hours, and every 2 hours from 6 – 12 hours after admission. Follow-up CT was performed after 24 hours. The hematoma volume was es-timated by CT and TCUS using the validated ABC/2 formula. The study was approved by the ethics committee of the capitol region of Denmark. Results: 25 patients completed all study procedures. Mean (SD) time from onset to CT was 108.6 (45.7) min. An active hematoma expansion marked by a significant positive mean expansion-pace (mL/h) was observed during the first 2 hours after admission CT, however, expansion was ob-served up to 4 hours after admission CT in individual patients. When stratified by CTA “spot sign” significantly positive mean hematoma expansion-pace was observed within 3 hours after admission CT (See figure). In patients with no spot sign on CTA, no significant hematoma ex-pansion was observed within 12 hours after admission (Friedman test, P=0.476). TCUS and CT volume assessment were correlated with an absolute volume deviation within 7mL and minimal systematic error (mean derivation 1.3mL (CI: -0.1; 2.6)). Conclusion: Active hematoma expansion occurs up to 4 hours after acute hospital admission in patients with spot sign. This study suggests a treatment window for haemostatic and antihypertensive treat-ment.
Karger_ESC London_2013
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