Hematoma Expansion Predictors: Laboratory and Radiological Risk Factors in Patients with Acute Intracerebral...

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Intracerebral hemorrhage (ICH) is a severe neurological emergency with high mortality.
• Early hematoma expansion (HE) is a critical predictor of poor outcomes in ICH patients.
• Identifying risk factors for HE can guide early detection and management strategies.

Purpose of the Study:

• To investigate demographic, laboratory, and radiological risk factors associated with early hematoma expansion (HE) in spontaneous ICH.
• To compare in-hospital mortality rates between ICH patients with and without HE.

Main Methods:

• Prospective evaluation of 136 spontaneous ICH patients for HE.
• Comparison of demographic, laboratory (including RDW, cholesterol, LDL-C, Ca), and radiological factors between groups with and without HE.
• Assessment of in-hospital mortality.

Main Results:

• Hematoma expansion (HE) occurred in 30% of patients, associated with greater neurological impairment and higher in-hospital mortality (53.6%).
• HE was linked to higher red blood cell distribution width (RDW), lower total cholesterol, LDL-C, and calcium levels.
• Radiological findings such as heterogeneous density, irregular hematoma shape, and the computed tomography angiography (CTA) spot sign were associated with HE.

Conclusions:

• Abnormal RDW, low cholesterol, LDL-C, and calcium levels are associated with HE in spontaneous ICH.
• Heterogeneous hematoma density, irregular shape, and the CTA spot sign are significant radiological predictors of HE.
• These findings aid in identifying high-risk ICH patients for targeted interventions to improve outcomes.