增强CT渗漏征象是原发性脑干出血血肿扩张及预后不良的预测指标

IF 1.3 Q4 CLINICAL NEUROLOGY

Brain Hemorrhages Pub Date : 2025-02-01 DOI:10.1016/j.hest.2024.10.003

Motohisa Koga, Yu Hasegawa, Jin Kikuchi, Aya Hashimoto, Keiichiro Furuta, Takehiro Makizono, Hidenobu Yoshitake, Kimihiko Orito, Motohiro Morioka

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引用次数: 0

摘要

目的：虽然血肿扩张是脑出血（ICH）患者预后不良的因素，但其对原发性脑干出血（PBSH）的影响尚不清楚。由于我们之前观察到计算机断层扫描（CT）上的“渗漏征象”（LS）是血肿扩张的重要预测指标，因此我们在此研究LS在PBSH中的作用。方法2013年1月至2023年8月，我院收治515例脑出血患者。36例PBSHs患者符合纳入标准，然后根据是否存在LS分为LS阳性（LS+）和LS阴性（LS-）组。我们在出院时评估血肿扩张和预后。结果LS+组患者入院时基线血肿体积较大，格拉斯哥昏迷评分较低，出院时预后明显差。亚组分析显示，CT上血肿大小为10mm3的患者，LS常在症状出现后100分钟内出现；此外，LS+组患者更容易出现血肿扩张，出院时预后较差。结论sls是入院时疾病严重程度、血肿扩张及出院时预后不良的重要预测指标。

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Leakage sign based on contrast-enhanced CT is a predictive marker for hematoma expansion and poor prognosis in primary brainstem hemorrhage

Objective

Although hematoma expansion is a poor prognostic factor in patients with intracerebral hemorrhage (ICH), its effect on primary brainstem hemorrhage (PBSH) remains unclear. Since we previously observed the “leakage sign” (LS) on computed tomography (CT) to be a significant predictor for hematoma expansion, we herein investigated the effect of LS in PBSH.

Methods

Between January 2013 and August 2023, 515 patients with ICH were admitted to our institute. Thirty-six patients with PBSHs met the inclusion criteria, who were then divided into LS-positive (LS+) and LS-negative (LS-) groups based on the presence of LS. We evaluated hematoma expansion and prognosis at discharge.

Results

Patients in the LS+ group had larger baseline hematoma volume and lower Glasgow Coma Scale scores on admission and significantly poor prognosis at discharge. Subgroup analysis revealed that LS was frequently observed within 100 min after the onset of symptoms in patients with a hematoma size of >10 mm³ on CT; additionally, patients in the LS+ group more frequently experienced hematoma expansion and had poor prognosis at discharge.