22 Jun Intensive Blood Pressure Reduction and Spot Sign in Intracerebral Hemorrhage
MedicalResearch.com Interview with:
Andrea Morotti, M.D.
Research Fellow in Neurology
Massachusetts General Hospital
Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The CT angiography (CTA) spot sign is a validated marker of Intracerebral Hemorrhage (ICH) expansion and may identify those subjects more likely to benefit from intensive blood pressure reduction.
We observed that less than 20% of ICH patients received a CTA as part of their diagnostic workup in a large, international randomized clinical trial. The performance of the spot sign in predicting ICH growth was suboptimal compared with what was reported in previous studies. Intensive blood pressure reduction did not improve functional outcome in spot sign positive patients.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Few ICH patients underwent a CTA and there is great variability in the CTA acquisition protocol across different institutions.
There is no evidence that spot sign positive patients benefit from intensive blood pressure treatment.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Standardization of the CTA acquisition protocol for spot sign detection is needed.
Non-contrast CT markers of ICH expansion have been recently reported. These NCCT signs may be a reliable alternative to the CTA spot sign for hematoma expansion prediction in clinical practice or in the setting of future randomized clinical trials.
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Citation: JAMA
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
Last Updated on June 22, 2017 by Marie Benz MD FAAD