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3D island sign on computed tomography predicts early perihematomal edema expansion and poor outcome in patients with intracerebral hemorrhage

Clinical neurology and neurosurgery, 2022-11, Vol.222, p.107443-107443, Article 107443 [Peer Reviewed Journal]

2022 ;Copyright Elsevier Limited Nov 2022 ;ISSN: 0303-8467 ;EISSN: 1872-6968 ;DOI: 10.1016/j.clineuro.2022.107443

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  • Title:
    3D island sign on computed tomography predicts early perihematomal edema expansion and poor outcome in patients with intracerebral hemorrhage
  • Author: Li, Yu-Lun ; Zhao, Rui ; Zheng, Yi-Neng ; Wei, Miao ; Li, Zuo-Qiao ; Hu, Xiao ; Li, Qi ; Lv, Fa-Jin
  • Subjects: Age ; Blood pressure ; Brain edema ; Cerebral hemorrhage ; Computed tomography ; Confidence intervals ; Edema ; Glasgow Coma Scale ; Hematoma ; Hemorrhage ; Logistics ; Medical imaging ; Mortality ; Patients ; Prognosis ; Regression analysis ; Therapeutic targets ; Tomography ; X-ray computed
  • Is Part Of: Clinical neurology and neurosurgery, 2022-11, Vol.222, p.107443-107443, Article 107443
  • Description: To determine the prognostics significance of the computed tomography (CT) 3D island sign for predicting early perihematomal edema (PHE) expansion and poor functional outcome in patients presenting with intracerebral hemorrhage (ICH). Between July 2011 and March 2017, patients with intracerebral hemorrhage who had undergone baseline CT within 6 h after ICH symptom onsets and follow-up CT in our hospital were included. Two different readers independently assessed the presence of 3D island sign on admission CT scan of each patient. Multivariable logistic regression analysis was used to analyze association between 3D island sign and early perihematomal edema expansion and poor functional outcome, separately. A total of 214 patients who met the inclusion criteria were included in our study, 3D island sign was observed in 60 patients (28.0 %) on admission CT scan. The multivariate logistic regression analysis demonstrated that baseline hematoma volume, time to baseline and follow-up CT scans and the presence of 3D island sign were predictors of early PHE expansion. After adjusting for age, baseline hematoma and edema volume, time to baseline and follow-up CT scans, GCS on admission, presence of intraventricular hemorrhage (IVH) and systolic blood pressure, the 3D island sign was an independently imaging marker for poor outcome (OR, 2.803; 95 % confidence interval, 1.189–6.609; P = 0.018). The 3D island sign in patients with intracerebral hemorrhage was a reliable predictor for early perihematomal edema expansion and poor functional outcome. It may serve as a potential therapeutic target for intervention. •A new noncontrast imaging marker for predicting early perihematomal edema is proposed.•The 3D island sign can be easily recognized on admission noncontrast CT scans.•Poor outcomes in intracerebral hemorrhage patients can be predicted by the 3D island sign.
  • Publisher: Assen: Elsevier B.V
  • Language: English
  • Identifier: ISSN: 0303-8467
    EISSN: 1872-6968
    DOI: 10.1016/j.clineuro.2022.107443
  • Source: ProQuest One Psychology
    ProQuest Central
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