{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T22:21:57Z","timestamp":1780525317226,"version":"3.54.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose:<\/jats:title>\n            <jats:p>The computed tomography angiography spot sign is associated with hematoma expansion, case fatality, and poor functional outcome in spontaneous supratentorial intracerebral hemorrhage (ICH). However, no data are available on the spot sign in spontaneous cerebellar ICH.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We investigated consecutive patients with spontaneous cerebellar ICH at 3 academic hospitals between 2002 and 2017. We determined patient characteristics, hematoma expansion (&gt;33% or 6 mL), rate of expansion, discharge and 90-day case fatality, and functional outcome. Poor functional outcome was defined as a modified Rankin Scale score of 4 to 6. Associations were tested using univariable and multivariable logistic regression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Three hundred fifty-eight patients presented with cerebellar ICH, of whom 181 (51%) underwent a computed tomography angiography. Of these 181 patients, 121 (67%) were treated conservatively of which 15 (12%) had a spot sign. Patients with a spot sign treated conservatively presented with larger hematoma volumes (median [interquartile range]: 26 [7\u201341] versus 6 [2\u201313],\n              <jats:italic>P<\/jats:italic>\n              =0.001) and higher speed of expansion (median [interquartile range]: 15 [24\u20133] mL\/h versus 1 [5\u20130] mL\/h,\n              <jats:italic>P<\/jats:italic>\n              =0.034). In multivariable analysis, presence of the spot sign was independently associated with death at 90 days (odds ratio, 7.6 [95% CI, 1.6\u201388],\n              <jats:italic>P<\/jats:italic>\n              =0.037). With respect to surgically treated patients (n=60, [33%]), 14 (23%) patients who underwent hematoma evacuation had a spot sign. In these 60 patients, patients with a spot sign were older (73.5 [9.2] versus 66.6 [15.4],\n              <jats:italic>P<\/jats:italic>\n              =0.047) and more likely to be female (71% versus 37%,\n              <jats:italic>P<\/jats:italic>\n              =0.033). In a multivariable analysis, the spot sign was independently associated with death at 90 days (odds ratio, 2.1 [95% CI, 1.1\u20134.3],\n              <jats:italic>P<\/jats:italic>\n              =0.033).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In patients with spontaneous cerebellar ICH treated conservatively, the spot sign is associated with speed of hematoma expansion, case fatality, and poor functional outcome. In surgically treated patients, the spot sign is associated with 90-day case fatality.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.120.033297","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T09:00:22Z","timestamp":1623747622000},"page":"2902-2909","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Computed Tomography Angiography Spot Sign, Hematoma Expansion, and Functional Outcome in Spontaneous Cerebellar Intracerebral Hemorrhage"],"prefix":"10.1161","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9304-8107","authenticated-orcid":true,"given":"Sanjula D.","family":"Singh","sequence":"first","affiliation":[{"name":"Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (S.D.S., A.D.W., B.N.M., K.S., M.E.G., J.R., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston."},{"name":"Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands (S.D.S., J.R.S., G.J.E.R., H.B.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9976-2459","authenticated-orcid":true,"given":"Marco","family":"Pasi","sequence":"additional","affiliation":[{"name":"University of Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience and Cognition, France (M.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7815-0207","authenticated-orcid":true,"given":"Floris H.B.M.","family":"Schreuder","sequence":"additional","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain Cognition and Behavior, Center for Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands (F.H.B.M.S., C.J.M.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6558-1155","authenticated-orcid":true,"given":"Andrea","family":"Morotti","sequence":"additional","affiliation":[{"name":"ASST Valcamonica, Neurology Unit, Esine (BS), Italy (A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper R.","family":"Senff","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands (S.D.S., J.R.S., G.J.E.R., H.B.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Warren","sequence":"additional","affiliation":[{"name":"Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (S.D.S., A.D.W., B.N.M., K.S., M.E.G., J.R., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenna N.","family":"McKaig","sequence":"additional","affiliation":[{"name":"Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (S.D.S., A.D.W., B.N.M., K.S., M.E.G., J.R., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Schwab","sequence":"additional","affiliation":[{"name":"Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (S.D.S., A.D.W., B.N.M., K.S., M.E.G., J.R., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2169-4457","authenticated-orcid":true,"given":"M. Edip","family":"Gurol","sequence":"additional","affiliation":[{"name":"Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (S.D.S., A.D.W., B.N.M., K.S., M.E.G., J.R., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1014-9138","authenticated-orcid":true,"given":"Jonathan","family":"Rosand","sequence":"additional","affiliation":[{"name":"Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (S.D.S., A.D.W., B.N.M., K.S., M.E.G., J.R., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston."},{"name":"Center for Genomic Medicine (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston."},{"name":"Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1792-8887","authenticated-orcid":true,"given":"Steven M.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (S.D.S., A.D.W., B.N.M., K.S., M.E.G., J.R., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (S.D.S., A.D.W., B.N.M., K.S., M.E.G., J.R., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8495-4578","authenticated-orcid":true,"given":"Catharina J.M.","family":"Klijn","sequence":"additional","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain Cognition and Behavior, Center for Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands (F.H.B.M.S., C.J.M.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel J.E.","family":"Rinkel","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands (S.D.S., J.R.S., G.J.E.R., H.B.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua N.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston."},{"name":"Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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