Abstract
The “Spot Sign” is a well-recognized radiographic predictor for hematoma expansion
in patients with intracerebral hemorrhages. Although the exact underlying pathophysiology
is unknown, it is generally assumed to be the site of blood vessel rupture and contrast
extravasation. We report a case of an 81-year-old man who presented with right basal
ganglia hemorrhage and the “Spot Sign” on computed tomography angiography. Conventional
angiography subsequently revealed a lenticulostriate artery aneurysm within the hematoma,
which was treated with surgical clipping. This case demonstrates that rare entities
such as lenticulostriate aneurysms must be kept in the differential diagnoses in order
to optimize patient management and improve clinical outcome.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical ImagingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Prospective validation of the computed tomographic angiography spot sign score for intracerebral hemorrhage.Stroke. 2013; 44: 3097-3102
- CT angiography “Spot Sign” predicts hematoma expansion in acute intracerebral hemorrhage.Stroke. 2007; 38: 1257-1262
- PREDICT/Sunnybrook ICH CTA study group.Lancet Neurol. 2012; 11: 307-314
- Contrast extravasation on CT angiography predicts hematoma expansion in intracerebral hemorrhage.Neurology. 2007; 68: 889-894
- Contrast extravasation on CT predicts mortality in primary intracerebral hemorrhage.AJNR Am J Neuroradiol. 2008; 29: 520-525
- Evolution of computed tomography angiography spot sign is consistent with a site of active hemorrhage in acute intracerebral hemorrhage.Stroke. 2014; 45: 277-280
- The pathogenesis of spontaneous cerebral hemorrhage.Proc. Pathol. Soc., Philadelphia1909
- Cerebral miliary aneurysms in hypertension.Am J Pathol. 1972; 66: 313-330
- Intracerebral microaneurysms and small cerebrovascular lesions.Brain. 1967; 90: 759-768
- Vascular and nonvascular mimics of the CT angiography “spot sign” in patients with secondary intracerebral hemorrhage.Stroke. 2008; 39: 1177-1183
- Rupture of lenticulostriate artery aneurysms: Report of 3 cases.J Neurosurg. 2014; 120: 426-433
- Small but consequential: Intracerebral hemorrhage caused by lenticulostriate artery aneurysm.Neurology. 2013; 80: e89-e91
Article info
Publication history
Published online: March 03, 2014
Accepted:
February 15,
2014
Received in revised form:
January 25,
2014
Received:
November 30,
2013
Footnotes
☆Disclosures: No funding or any other form of support was received for this work. There are no disclosures to report by any of the authors.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
