{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:12:04Z","timestamp":1792141924661,"version":"4.4.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Severe hematoma expansion (sHE) has the strongest impact on intracerebral hemorrhage (ICH) outcome. We investigated the predictors of sHE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective analysis of ICH patients admitted at nine sites in Italy, Germany, China, and Canada. The following imaging features were analyzed: non-contrast CT (NCCT) hypodensities, heterogeneous density, blend sign, irregular shape, and CT angiography (CTA) spot sign. The outcome of interest was sHE, defined as volume increase &amp;gt;66% and\/or &amp;gt;12.5 from baseline to follow-up NCCT. Predictors of sHE were explored with logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 1472 patients were included (median age 73, 56.6% males) of whom 223 (15.2%) had sHE. Age (odds ratio (OR) per year, 95% confidence interval (CI), 1.02 (1.01\u20131.04)), Anticoagulant treatment (OR 3.00, 95% CI 2.09\u20134.31), Glasgow Coma Scale (OR 0.93, 95% CI 0.89\u20130.98), time from onset\/last known well to imaging, (OR per h 0.96, 95% CI 0.93\u20130.99), and baseline ICH volume, (OR per mL 1.02, 95% CI 1.02\u20131.03) were independently associated with sHE. Ultra-early hematoma growth (baseline volume\/baseline imaging time) was also a predictor of sHE (OR per mL\/h 1.01, 95% CI 1.00\u20131.02). All NCCT and CTA imaging markers were also predictors of sHE. Amongst imaging features NCCT hypodensities had the highest sensitivity (0.79) whereas the CTA spot sign had the highest positive predictive value (0.51).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>sHE is common in the natural history of ICH and can be predicted with few clinical and imaging variables. These findings might inform clinical practice and future trials targeting active bleeding in ICH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873241247436","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T01:15:01Z","timestamp":1713316501000},"page":"623-629","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":26,"title":["Predictors of severe intracerebral hemorrhage expansion"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6558-1155","authenticated-orcid":false,"given":"Andrea","family":"Morotti","sequence":"first","affiliation":[{"name":"Department of Continuity of Care and Frailty, Neurology Unit, ASST-Spedali Civili, Brescia, Italy 1"},{"name":"Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9144-148X","authenticated-orcid":false,"given":"Qi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jawed","family":"Nawabi","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Campus Mitte, Humboldt-Universit\u00e4t zu Berlin, Freie Universit\u00e4t Berlin, Berlin Institute of Health, Berlin, Germany 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Busto","sequence":"additional","affiliation":[{"name":"Department of Biomedical Experimental and Clinical, Neuroradiology, University of Firenze, AOU Careggi, Firenze, Italy 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Mazzacane","sequence":"additional","affiliation":[{"name":"U.C. Malattie Cerebrovascolari e Stroke Unit, IRCCS Fondazione Mondino, Pavia, Italia 6"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5227-1502","authenticated-orcid":false,"given":"Anna","family":"Cavallini","sequence":"additional","affiliation":[{"name":"U.C. Malattie Cerebrovascolari e Stroke Unit, IRCCS Fondazione Mondino, Pavia, Italia 6"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2802-1626","authenticated-orcid":false,"given":"Ashkan","family":"Shoamanesh","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, McMaster University\/Population Health Research Institute, Hamilton, ON, Canada 7"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Morassi","sequence":"additional","affiliation":[{"name":"Unit of Neuroradiology, Department of Diagnostic Imaging, Fondazione Poliambulanza Hospital, Brescia, Italy 8"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frieder","family":"Schlunk","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Medical Centre, University of Freiburg, Freiburg, Germany 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