The CT Swirl Sign Is Associated with Hematoma Expansion in Intracerebral Hemorrhage

Abstract

BACKGROUND AND PURPOSE: Hematoma expansion is an independent determinant of poor clinical outcome in intracerebral hemorrhage. Although the “spot sign” predicts hematoma expansion, the identification requires CT angiography, which limits its general accessibility in some hospital settings. Noncontrast CT, without the need for CT angiography, may identify sites of active extravasation, termed the “swirl sign.” We aimed to determine the association of the swirl sign with hematoma expansion. MATERIALS AND METHODS: Patients with spontaneous intracerebral hemorrhage between 2007 and 2014 who underwent an initial and subsequent noncontrast CT at a single center were retrospectively identified. The..