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Extended analysis of the spot sign score's performance

Nature Reviews Neurology volume 6, page 352 (2010)Cite this article

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We have read with great interest Becker and Tirschwell's commentary (Stroke: 'Spotting' patients at the highest risk of hematoma growth. Nat. Rev. Neurol. 5, 526–528; (2009))1 on our work relating to the use of the CT angiography spot sign and the 'spot sign score' in the selection of patients with primary intracerebral hemorrhage for early hemostatic therapy.2 Here, we provide answers to the questions raised in their commentary regarding the sensitivity and specificity of each spot sign score group in our study for the prediction of hematoma expansion and, in addition, poor clinical outcome (Table 1).

Table 1 The spot sign score in primary intracerebral hemorrhage
Full size table

Becker and Tirschwell's group was the first to recognize that the presence of contrast extravasation on CT angiography was a strong predictor of mortality in patients with primary intracerebral hemorrhage,3 which has been corroborated by other groups.4,5 Moreover, subsequent studies have also associated the presence of contrast extravasation on CT angiography with hematoma expansion and poor clinical outcome.2,4,5,6,7,8,9,10

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References

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Acknowledgements

This research was supported, in part, by a National Institute of Neurological Disorders and Stroke grant (K23NS059774) to J. N. Goldstein, an American Heart Association Grant-in-Aid (0755984T) to J. Rosand, and a NIH Specialized Programs of Translational Research in Acute Stroke grant to M. H. Lev.

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Authors and Affiliations

  1. Division of Neuroradiology, Mallinckrodt Institute of Radiology, Washington University, Campus Box 8131, 510 South Kingshighway Boulevard, Saint Louis, 63110, MO, USA

    Josser E. Delgado Almandoz

  2. Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, 02114, MA, USA

    Albert J. Yoo, Michael J. Stone, Pamela W. Schaefer, Michael H. Lev, R. Gilberto Gonzalez & Javier M. Romero

  3. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, 02114, MA, USA

    Joshua N. Goldstein

  4. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, 02114, MA, USA

    Jonathan Rosand & Alexandra Oleinik

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  1. Josser E. Delgado Almandoz
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Correspondence to Josser E. Delgado Almandoz.

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Competing interests

M. H. Lev has acted as a consultant for GE Healthcare, Millennium Pharmaceuticals and Vernalis. He has also received honoraria for speaking from GE Healthcare. The other authors declare no competing interests.

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Delgado Almandoz, J., Yoo, A., Stone, M. et al. Extended analysis of the spot sign score's performance. Nat Rev Neurol 6, 352 (2010). https://doi.org/10.1038/nrneurol.2009.152-c1

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