Evidence map›Paper›PMID 42525110›Full record

ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026

The frequency and predictors of hematoma expansion in wake-up intracerebral hemorrhage.

Han Wang, Zijie Wang, Rui Cheng, Xiao Hu, Chu Chen, Juan Li, Tiannan Yang, Sijia Liu, Yue Sun, Qi Li

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Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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10 authors.

Han Wang *Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Zijie Wang *Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Rui Cheng *Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Xiao HuDepartment of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Chu ChenDepartment of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Juan LiDepartment of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Tiannan YangDepartment of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Sijia LiuDepartment of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Yue SunDepartment of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Qi LiDepartment of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China. qili_md@ahmu.edu.cn.ORCID http://orcid.org/0000-0002-9144-148X

Funding

Clinical and Translational Research Project of Anhui Province No. 202427b10020053Clinical and Translational Research Project of Anhui Province No. 202427b10020090Excellent Research and Innovation Team Project of Anhui Province No. 2024AH010014Health Research Program of Anhui No. 2024Aa40015National Natural Science Foundation of China No. 82471368
6 · The paper itself

Abstract

backgroundHematoma expansion (HE) is a key determinant of poor outcomes in intracerebral hemorrhage (ICH), but its frequency and predictors in wake-up ICH remain insufficiently characterized. This study aimed to compare HE between wake-up and clear-onset ICH and to identify predictors of HE in wake-up ICH.

methodsWe analyzed patients with spontaneous ICH from a prospective cohort between August 2022 and September 2025. The primary outcome was HE defined as an absolute increase in volume > 6 mL or > 33% from baseline on follow-up computed tomography (CT). Poor outcome was defined as a modified Rankin Scale (mRS) score of 3-6 at 3 months. Baseline characteristics, HE rates, and outcomes were compared between wake-up ICH and clear-onset ICH groups. Logistic regression analyses were performed to identify predictors of HE and poor outcome in wake-up ICH.

resultsAmong 415 patients, 66 (15.9%) had wake-up ICH. The frequency of HE was comparable between wake-up and clear-onset ICH (35.2% vs. 24.7%; p = 0.115), as were 3-month functional outcomes and mortality (all p > 0.05). HE was independently associated with poor 3-month outcome among wake-up ICH. Hypodensities (OR = 3.96, 95% CI: 1.08-15.77, p = 0.044) and irregular shape (OR = 3.95, 95% CI: 1.09-15.49, p = 0.040) were independently associated with HE among wake-up ICH.

conclusionHE is common and associated with poor outcomes in wake-up ICH. Noncontrast CT markers, including hypodensities and irregular shape, may serve as imaging markers for risk stratification of HE in wake-up ICH.

Indexed as

Cerebral HemorrhageHematomaAgedDisease ProgressionFemaleHumansMaleMiddle AgedProspective StudiesTomography, X-Ray ComputedHematoma expansionImaging markersIntracerebral hemorrhageNoncontrast computed tomographyWake-up stroke

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PMID42525110

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