Deans' stroke musings: Non-contrast CT Markers of Intracerebral Hemorrhage Expansion: The influence of onset-to-CT time

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, December 3, 2022

Non-contrast CT Markers of Intracerebral Hemorrhage Expansion: The influence of onset-to-CT time

Well we've known of hemorrhage expansion for a while. Since you're not willing to actually solve the problem. I'D HAVE YOU ALL FIRED!

hemorrhage expansion (2 posts to December 2021) And I can see Google Scholar research on this back to 2004, which gives you a complete proof of how fucking incompetent our stroke leadership is.

Non-contrast CT Markers of Intracerebral Hemorrhage Expansion: The influence of onset-to-CT time

Andrea Morotti https://orcid.org/0000-0002-6558-1155 andrea.morotti85@gmail.com, Qi Li https://orcid.org/0000-0002-9144-148X, and Francesco Arba https://orcid.org/0000-0003-3941-7383View all authors and affiliations

Express Articles

Background:

Hematoma expansion (HE) is an appealing therapeutic target in intracerebral hemorrhage (ICH) and non-contrast computed tomography (NCCT) features are promising predictors of HE.

Aims:

We investigated whether onset-to-CT time influences the diagnostic performance of NCCT markers for HE.

Methods:

retrospective multicentre analysis of patients with primary ICH. The following NCCT markers were analyzed: hypodensities, heterogeneous density, blend sign, and irregular shape. HE was defined as growth > 6 mL and/or > 33%. We calculated the sensitivity, specificity, positive and negative predictive values (PPV and NPV) of NCCT markers for HE, stratified by onset-to-CT time (< 2 h, 2-4 h, 4-6 h, >6 h).

Results:

We included 1135 patients, (median age 69, 53% males) of whom 307 (27%) experienced HE.

Overall hypodensities had the highest sensitivity (0.68) and blend sign the highest specificity (0.87) for HE. Hypodensities were more common and had higher sensitivity (0.80) in patients with imaging within 2 h. The same result was observed for heterogeneous density whereas irregular shape had a similar prevalence across time strata and higher sensitivity (0.79) beyond 6 h from onset. The frequency of blend sign increased with longer onset-to-CT-time whereas its specificity declined after 6 h from onset.

Conclusion:

the diagnostic performance of NCCT markers is influenced by imaging time. Hypodensities identified four out of five patients with HE within 2 h from onset whereas irregular shape performed better in late presenters. Our findings may improve the use of NCCT markers in future studies and trials targeting HE.