Evidence map›Paper›PMID 39150218›Full record

ArticleEuropean stroke journal2025

Co-localization of NCCT hypodensity and CTA spot sign predicts substantial intracerebral hematoma expansion: The Black-&-White sign.

Umberto Pensato, Koji Tanaka, MacKenzie Horn, Ericka Teleg, Abdulaziz Sulaiman Al Sultan, Linda Kasickova, Tomoyuki Ohara, Piyush Ojha, Sina Marzoughi, Ankur Banerjee and 5 more

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In one paragraph

Article in European stroke journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Umberto PensatoIRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.ORCID 0000-0002-4042-4735
Koji TanakaDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
MacKenzie HornDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Ericka TelegDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Abdulaziz Sulaiman Al SultanDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Linda KasickovaDepartment of Neurology, University Ostrava, Ostrava, Czech Republic.ORCID 0000-0002-6780-2206
Tomoyuki OharaDepartment of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Piyush OjhaDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Sina MarzoughiDepartment of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada.
Ankur BanerjeeDepartment of Medicine, Division of Neurology, University of Alberta, Edmonton, AB, Canada.
Girish KulkarniDepartment of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India.
Dar DowlatshahiDepartment of Medicine, Division of Neurology, University of Ottawa, Ottawa, ON, Canada.
Mayank GoyalDepartment of Radiology, University of Calgary, Calgary, AB, Canada.ORCID 0000-0001-9060-2109
Bijoy K MenonDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Andrew M DemchukDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExisting radiological markers of hematoma expansion (HE) show modest predictive accuracy. We aim to investigate a novel radiological marker that co-localizes findings from non-contrast CT (NCCT) and CT angiography (CTA) to predict HE.

methodsConsecutive acute intracerebral hemorrhage patients admitted at Foothills Medical Centre in Calgary, Canada, were included. The Black-&-White sign was defined as any visually identified spot sign on CTA co-localized with a hypodensity sign on the corresponding NCCT. The primary outcome was hematoma expansion (⩾6 mL or ⩾33%). Secondary outcomes included absolute (<3, 3-6, 6-12, ⩾12 mL) and relative (0%, <25%, 25%-50%, 50%-75%, or >75%) hematoma growth scales.

resultsTwo-hundred patients were included, with 50 (25%) experiencing HE. Forty-four (22%) showed the spot sign, 69 (34.5%) the hypodensity sign, and 14 (7%) co-localized both as the Black-&-White sign. Those with the Black-&-White sign had higher proportions of HE (100% vs 19.4%,

conclusionThe Black-&-White sign is a robust predictor of hematoma expansion occurrence and severity, yet further validation is needed to confirm these compelling findings.

Indexed as

Cerebral AngiographyCerebral HemorrhageComputed Tomography AngiographyHematomaTomography, X-Ray ComputedAgedAged, 80 and overFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective Studiesblack and white signHemorrhagic strokehemostatic therapyintracranial hemorrhageneuroimagingradiological markers

Identifiers

PMID39150218
PMCPMC11569561

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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.