NEUROSURGICAL EMERGENCY
Online ISSN : 2434-0561
Print ISSN : 1342-6214
Contrast Extravasation on CT Angiography Predicts Hemorrhage Expansion in Traumatic Intracranial Hemorrhage
Fumihisa KishiTakatoshi FujimotoHiromichi HayamiMegumi ChataniHajime KimuraKazunori OkudaShigeru Shiono
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JOURNAL OPEN ACCESS

2019 Volume 24 Issue 1 Pages 20-27

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Abstract

  Contrast extravasation (CE) within spontaneous intracerebral hemorrhage is a well‒described predictor of hemorrhage expansion, poor clinical outcome, and mortality. Our purpose was to evaluate CE as a predictor of hemorrhage expansion in traumatic intracranial hemorrhage including subdural hemorrhage, epidural hemorrhage and intracerebral hemorrhage. We retrospectively reviewed the cases of 43 patients who presented to our emergency department over a 5‒year period with traumatic intracranial hemorrhage and underwent CT Angiography (CTA) at admission and follow‒up CT within 4 hours. The presence of CE was evaluated in the arterial phase and venous phase of CTA, with CE classified as active extravasation or post‒contrast leakage. Hemorrhage expansion of the subdural hemorrhage was detected in 91% of the patients in the CE (+) group, whereas expansion was only observed in 21% of the CE (-) group (P<0.001). Hemorrhage expansion of the intracerebral hemorrhage was detected in 100% of the patients in the CE (+) group, whereas expansion was only observed in 50% of the CE (-) group (P<0.001). No significant difference in hemorrhage expansion or the hemorrhage expansion rate was found between active extravasation and postcontrast leakage. CE was a predictor of hemorrhage expansion in our series of patients with traumatic intracranial hemorrhage.

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© 2019 Japan Society of Neurosurgical Emergency
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