@ARTICLE{10.3389/fneur.2014.00186, AUTHOR={Ovesen, Christian and Havsteen, Inger and Rosenbaum, Sverre and Christensen, Hanne}, TITLE={Prediction and Observation of Post-Admission Hematoma Expansion in Patients with Intracerebral Hemorrhage}, JOURNAL={Frontiers in Neurology}, VOLUME={5}, YEAR={2014}, URL={https://www.frontiersin.org/articles/10.3389/fneur.2014.00186}, DOI={10.3389/fneur.2014.00186}, ISSN={1664-2295}, ABSTRACT={Post-admission hematoma expansion in patients with intracerebral hemorrhage (ICH) comprises a simultaneous major clinical problem and a possible target for medical intervention. In any case, the ability to predict and observe hematoma expansion is of great clinical importance. We review radiological concepts in predicting and observing post-admission hematoma expansion. Hematoma expansion can be observed within the first 24 h after symptom onset, but predominantly occurs in the early hours. Thus capturing markers of on-going bleeding on imaging techniques could predict hematoma expansion. The spot sign observed on computed tomography angiography is believed to represent on-going bleeding and is to date the most well investigated and reliable radiological predictor of hematoma expansion as well as functional outcome and mortality. On non-contrast CT, the presence of foci of hypoattenuation within the hematoma along with the hematoma-size is reported to be predictive of hematoma expansion and outcome. Because patients tend to arrive earlier to the hospital, a larger fraction of acute ICH-patients must be expected to undergo hematoma expansion. This renders observation and radiological follow-up investigations increasingly relevant. Transcranial duplex sonography has in recent years proven to be able to estimate hematoma volume with good precision and could be a valuable tool in bedside serial observation of acute ICH-patients. Future studies will elucidate, if better prediction and observation of post-admission hematoma expansion can help select patients, who will benefit from hemostatic treatment.} }