22. European Stroke Conference 2 Intracerebral/subarachnoid haemorrhage and venous diseases 10:40 - 10:50 Perihematomal edema is greater at baseline in the presence of a CTA spot sign but does not predict hematoma expansion independent of ICH volume D. Rodriguez-Luna1, T. Stewart2, S. Subramaniam3, D. Dowlatshahi4, J. Kosior5, R.I. Aviv6, C.A. Molina7, Y. Silva Blas8, I. Dzialowski9, C. Lum10, A. Czlonkowska11, V. Padma12, J. Roy13, M.D. Hill14, A.M. Demchuk15 for the PREDICT/Sunnybrook ICH CTA study group Vall d’Hebron University Hospital, Barcelona, SPAIN1,University of Calgary, Calgary, CANADA2, University of Calgary, Calgary, CANADA3, University of Ottawa, Calgary, CAN-ADA4, University of Calgary, Calgary, CANADA5, University of Toronto, Toronto, CANADA6, Vall d’Hebron University Hospital, Barcelona, SPAIN7, Dr Josep Trueta University Hospital, Girona, SPAIN8, University of Dresden, Dresden, GERMANY9, University of Ottawa, Ottawa, CANADA10, Institute of Psychiatry and Neurology of Warsaw, Warsaw, POLAND11, All India Institute of Medical Sciences, New Delhi, INDIA12, AMRI Hos-pital Kolkata, Kolkata, INDIA13, University of Calgary, Calgary, CANADA14, University of Calgary, Calgary, CANADA15 Background: Similarly to intracerebral hemorrhage (ICH), perihematomal edema (PHE) in-creases with time from onset. A small degree of PHE relative to ICH may suggest a very early timepoint from onset or actively bleeding ICH and therefore predict a higher likelihood of he-matoma expansion (HE). However, the relationship between PHE, ICH and HE has not been established. Thus, we aimed to investigate the link between PHE and ICH by time and their re-lationship with the CTA spot sign and HE. Methods: The PREDICT study was a multicentric, prospective, observational cohort study of ICH patients <6 hours. All study cohort subjects with available baseline CT scan images (n=377) were included in this analysis. Volumes and diameters of total lesion (ICH+PHE), ICH and PHE were measured systematically by 2 blinded investigators, respectively. Diameter mea-surements were taken in the axial CT slice with the largest ICH area. Significant HE was de-fined as ICH enlargement >33% or >6mL at 24 hours. Results: Correlation between volume and diameter measurements was strong for total lesion (r=0.9; p<0.001) and ICH (r=0.88; p<0.001), but moderate for PHE (r=0.43; p<0.001). PHE represented a half of the total lesion volume at baseline (Table). PHE volume and diameter were not related to time from onset to baseline CT, although PHE/ICH diameter (p=0.017) and volume (p=0.061) ratios were higher the later the baseline CT scan was performed. Spot-sign patients (29.7%) had more baseline PHE, ICH and total lesion than spot-negative patients (Ta-ble). HE analysis was limited to 322 patients with follow-up CT before rFVIIa or surgical inter-vention. HE patients (32%) presented with higher PHE, ICH and total lesion volumes (Table). Baseline PHE diameter and volume ratios however did not predict subsequent HE. Conclusion: Edema represents about half of total lesion volume in acute ICH. Edema and ICH are larger in the presence of a CTA spot sign. Edema alone does not predict subsequent hemato-ma expansion. 128 © 2013 S. Karger AG, Basel Scientific Programme
Karger_ESC London_2013
To see the actual publication please follow the link above