Predicting hematoma growth in spontaneous intracerebral hemorrhage: A simplified non-contrast computed tomography based five-point grading approach

Figure 1 Flowchart depicting patient enrolment. NCCT: Non-contrast computed tomography.

Figure 2 Calculation of volume of intracerebral hematoma on non-contrast computed tomography scan of brain using ABC/2. A: Maximum width (red line) and maximum length (yellow line) of hematoma in cm; B: Longest cranio-caudal measurement of hematoma on the coronal section. Multiplying the three dimensions and dividing it by 2 yields the final volume in milliliters.

Figure 3 Swirl sign in a 59-year-old man who presented with sudden onset of left-sided weakness. A: Axial non-contrast computed tomography (NCCT) image performed 1.5 hours after hospital admission showed a right basal ganglia bleed with a swirl sign and intraventricular hemorrhage (blue arrowhead); B: Follow-up NCCT 6-hours later showed a significant hematoma expansion.

Figure 4 Black hole sign in 68-year-old woman who presented with sudden onset of aphasia and right-sided weakness. A: Axial non-contrast computed tomography (NCCT) image performed 3-hours after hospital admission showed left basal ganglia hematoma with a black hole sign (blue arrow); B: Follow-up NCCT 6-hours later showed a significant hematoma expansion with intra-ventricular extension.

Figure 5 Island sign in a 66-year-old man who presented with sudden onset of right-sided weakness. A: Non-contrast computed tomography (CT) image done 3-hours after symptom onset reveals acute hematoma in left basal ganglia hematoma with an island sign (blue arrows); B: Follow-up CT scan performed 3-hours after first CT demonstrated significant hematoma growth.