Risk Factors for Enlargement of Intracerebral Hematoma after Hospitalization

Summary: Objective: Patients with spontaneous intracerebral hematoma (ICH) often develop symptoms associated with hematoma expansion, which worsens their prognosis. We evaluated the risk factors for the enlargement of hematoma. Materials and Methods: Stroke patients are diagnosed by CT followed by perfusion CT and 3D-CT angiography as a department policy. We retrospectively reviewed 123 patients hospitalized between Apr. 2008 and Dec. 2010. Among them, 27 patients (22.0%) showed hematoma enlargement within 24 hours after hospitalization. We compared the clinical characteristics of patients with and without hematoma enlargement. Results: There were significant differences in the initial size of the hematoma, spot sign, and pretreatment with anticoagulants, but not in hypertension, diabetes mellitus, or pretreatment with antiplatelets. Conclusions: We confirmed that the initial size, spot sign, and anticoagulants were risk factors for hematoma enlargement. Careful follow-up is needed for ICH patients with these factors.