[CT findings of ongoing intracerebral hematoma]

Three cases of ongoing intracerebral hematoma are reported. In all cases, a very small hematoma on the initial CT taken within 2 hours after onset increased in size to such an extent that surgical intervention was necessary. A round radiolucent zone in high density clots was seen on the initial CT of all cases. The attenuation values of each pixels in hematoma formed V-figure in profile display, vfrying from minimum density (40-60) in the center of radiolucent zone to the maximum density (80-90) in peripheral clots. Experimental data have established that the density of blood in circulation and, therefore, one immediately after extravasation is directly related to the patient's hemoglobin and hematocrit levels. Hemoconcentration following clot formation and serum absorption in the brain tissue results in further increase of hematoma density. The radiolucent zone in a intracerebral hematoma suggests extravasated fresh blood. Therefore, we conclud that this is an evidence of active bleeding which calls for immediate surgery.