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Related Experiment Video

Updated: Nov 11, 2025

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
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[Intracerebral Hemorrhage].

Masafumi Hiramatsu1, Jun Haruma, Tomohito Hishikawa

  • 1Department of Neurological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University.

No Shinkei Geka. Neurological Surgery
|March 25, 2021
PubMed
Summary

CT angiography (CTA) aids in diagnosing intracerebral hemorrhage (ICH). CTA can identify "spot sign" and "leakage sign," predicting hematoma expansion and rebleeding risk.

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Area of Science:

  • Neuroradiology
  • Neuroimaging

Background:

  • Intracerebral hemorrhage (ICH) diagnosis relies heavily on CT angiography (CTA).
  • Early identification of ICH and its progression is critical for patient outcomes.

Observation:

  • An 85-year-old female presented with altered consciousness and right hemiparesis.
  • Initial non-contrast CT revealed left thalamic ICH with a "swirl sign."
  • CTA demonstrated "spot sign" and "leakage sign" in early and delayed phases, respectively, without vascular anomalies.

Findings:

  • CTA is crucial for differentiating secondary ICH causes and detecting hematoma expansion markers.
  • The "spot sign" on CTA is a validated imaging marker for predicting hematoma expansion.
  • Delayed CTA phases can indicate active bleeding or rebleeding risk.

Implications:

  • CTA enhances the diagnostic accuracy of ICH and guides treatment decisions.
  • Identifying imaging markers like the "spot sign" allows for timely intervention to prevent hematoma enlargement.
  • This case highlights the combined utility of non-contrast CT and CTA in managing ICH.