Trial reportNeurology2017
Blood pressure reduction and noncontrast CT markers of intracerebral hemorrhage expansion.
Registry-linked trialAbstract readMulticenter StudyRandomized Controlled TrialValidation Study
In one paragraph
Trial report in Neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01176565 (Antihypertensive Treatment of Acute Cerebral Hemorrhage), which is not on this map. Cited by 59 papers, 2 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 2 pooled it
13.0field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH)-II: A Phase III Randomized Multicenter Clinical Trial of Blood Pressure Reduction for Hypertension in Acute Intracerebral Hemorrhage
Who cites it
59 citing papers in PubMed, 2 syntheses or guidelines pooled it, 139 citations in OpenAlex.
- Island Sign Predicts Hematoma Expansion and Poor Outcome After Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.Frontiers in neurology · 2020Pooled it
- Heterogeneity Signs on Noncontrast Computed Tomography Predict Hematoma Expansion after Intracerebral Hemorrhage: A Meta-Analysis.BioMed research international · 2018Pooled it
- Tranexamic acid for acute intracerebral haemorrhage growth based on imaging assessment (TRAIGE): a multicentre, randomised, placebo-controlled trial.Stroke and vascular neurology · 2021Trial
- Ultra-Early Blood Pressure Reduction Attenuates Hematoma Growth and Improves Outcome in Intracerebral Hemorrhage.Annals of neurology · 2020Trial
- Article
- Review
- Clinical and Radiological Predictors for Early Hematoma Expansion After Spontaneous Intracerebral Hemorrhage: A Retrospective Study.Neurology international · 2025Article
- Predicting hemorrhage expansion in patients with hypertensive intracerebral hemorrhage: the HE-VSD-A2TP score.Frontiers in neurology · 2025Article
- Impact of type 2 diabetes mellitus on hematoma expansion and clinical outcomes in patients with spontaneous intracranial hematoma.Frontiers in surgery · 2025Article
- Prediction of hematoma expansion in spontaneous intracerebral hemorrhage using a multimodal neural network.Scientific reports · 2024Article
- Predictors of Intracranial Hemorrhage Volume Expansion in Patients Receiving Factor Xa Inhibitors in ANNEXA-4: Time and Severity Matter Most.Stroke (Hoboken, N.J.) · 2024Article
- Association of pulse pressure with hematoma expansion in patients with spontaneous supratentorial intracerebral hemorrhage.Frontiers in neurology · 2024Article
- Article
- The relationship between hematoma morphology and intraventricular hemorrhage in supratentorial deep intracerebral hemorrhage.Quantitative imaging in medicine and surgery · 2023Article
- NCCT Markers of Intracerebral Hemorrhage Expansion Using Revised Criteria: An External Validation of Their Predictive Accuracy.AJNR. American journal of neuroradiology · 2023Article
- The "SALPARE study" of spontaneous intracerebral haemorrhage-part 2-early CT predictors of outcome in ICH: keeping it simple.Neurological research and practice · 2023Article
- Using Radiomics and Convolutional Neural Networks for the Prediction of Hematoma Expansion After Intracerebral Hemorrhage.International journal of general medicine · 2023Article
- A predictive nomogram for intracerebral hematoma expansion based on non-contrast computed tomography and clinical features.Neuroradiology · 2022Article
- Machine learning prediction of hematoma expansion in acute intracerebral hemorrhage.Scientific reports · 2022Article
- Aspirin does not affect hematoma growth in severe spontaneous intracranial hematoma.Neurosurgical review · 2022Article
Corrections and comments
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Authors and funding
15 authors at 3 institutions in 2 countries.
Andrea MorottiFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston. andrea.morotti85@gmail.com.
Gregoire BoulouisFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
Javier M RomeroFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
H Bart BrouwersFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
Michael J JesselFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
Anastasia VashkevichFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
Kristin SchwabFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
Mohammad Rauf AfzalFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
Christy CassarlyFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
Steven M GreenbergFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
Reneé Hebert MartinFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
Adnan I QureshiFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
Jonathan RosandFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
Joshua N GoldsteinFrom the Department of Neurology, Division of Neurocritical Care and Emergency Neurology (A.M., J.M.R., J.N.G.), Neuroradiology Service, Department of Radiology (J.M.R.), the J.P. Kistler Stroke Research Center (A.M., G.B., J.M.R., M.J.J., A.V., K.S., S.M.G., J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neuroradiology (G.B.), Université Paris Descartes, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France; Department of Neurosurgery (H.B.B.), Brain Center, Rudolf Magnus University Medical Center, Utrecht, the Netherlands; Zeenat Qureshi Stroke Research Center (M.R.A., A.I.Q.), University of Minnesota, Minneapolis; and Department of Public Health Sciences (C.C., R.H.M.), Medical University of South Carolina, Charleston.
ATACH-II and NETT investigators
University Medical Center Utrecht · NLUniversity of Minnesota · USCentraCare Health System · US
Funding
SCORE-IT: The CTA Spot Sign Score in Acute Cerebral HemorrhageR01NS073344 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI ROSAND, JONATHAN · 2011 to 2015
$2.2MNINDS NIH HHS R01 NS073344
Abstract
objectiveTo validate various noncontrast CT (NCCT) predictors of hematoma expansion in a large international cohort of ICH patients and investigate whether intensive blood pressure (BP) treatment reduces ICH growth and improves outcome in patients with these markers.
methodsWe analyzed patients enrolled in the Antihypertensive Treatment of Acute Cerebral Hemorrhage II (ATACH-II) randomized controlled trial. Participants were assigned to intensive (systolic BP <140 mm Hg) vs standard (systolic BP <180 mm Hg) treatment within 4.5 hours from onset. The following NCCT markers were identified: intrahematoma hypodensities, black hole sign, swirl sign, blend sign, heterogeneous hematoma density, and irregular shape. ICH expansion was defined as hematoma growth >33% and unfavorable outcome was defined as modified Rankin Scale score >3 at 90 days. Logistic regression was used to identify predictors of ICH expansion and explore the association between NCCT signs and clinical benefit from intensive BP treatment.
resultsA total of 989 patients were included (mean age 62 years, 61.9% male), of whom 186/869 experienced hematoma expansion (21.4%) and 361/952 (37.9%) had unfavorable outcome. NCCT markers independently predicted ICH expansion (all
conclusionsNCCT signs reliably identify ICH patients at high risk of hematoma growth. However, we found no evidence that patients with these markers specifically benefit from intensive BP reduction. CLINICALTRIALSGOV IDENTIFIER: NCT01176565.
Indexed as
Tomography, X-Ray ComputedAntihypertensive AgentsBlood PressureBrainCerebral HemorrhageDisease ProgressionFemaleHematomaHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisObserver VariationPrognosisSensitivity and SpecificityAntihypertensive Agents
Identifiers
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Registered trials
NCT01176565ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.