• Marcos Rosa Júnior, Antônio José da Rocha, Antônio Carlos Martins Maia Júnior, Nelson Saade, and Rubens José Gagliardi.
• From the *Section of Neuroradiology Santa Casa de Misericórdia de São Paulo, São Paulo SP; †Section of Radiology, Federal University of Espírito Santo, Vitória ES; ‡Division of Neurosurgery, and §Division of Neurology, Santa Casa de Misericórdia de São Paulo, São Paulo SP, Brazil.
• J Comput Assist Tomogr. 2015 Mar 1;39(2):217-21.

ObjectiveIntracerebral hemorrhage (ICH) occurs in 10% to 15% of all strokes and is accompanied by high rates of mortality, disability, and neurological sequelae. Our aim was to assess the presence and prognostic implications of the active extravasation of contrast within the hemorrhage (spot sign) in a series of patients with secondary ICH.MethodsWe analysed 59 subjects who arrived at a tertiary hospital with secondary ICH and a brain parenchyma hemorrhage greater than 2.0 cm in any axis.ResultsSpot sign was observed in 11 subjects, including 8 patients with saccular aneurysm, 1 with arteriovenous malformation, 1 with coagulation disorder and 1 with venous sinus thrombosis. A 37.5% mortality rate was documented in the spot sign-negative group, whereas the presence of this imaging finding was followed by an 81.8% in-hospital mortality rate.ConclusionsSpot sign was correlated with vascular etiology and was a predictor of mortality in our series of patients.

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