Ultra-Early Hematoma Expansion Is Associated With Ongoing Hematoma Growth and Poor Functional Outcome | Stroke
Background: There is limited data on ultra-early hematoma growth dynamics and its clinical relevance in primary intracerebral hemorrhage (ICH). We aimed to estimate the incidence of hematoma expansion (HE) within the hyperacute period of ICH, describe hematoma dynamics over time, investigate the associations between ultra-early HE and clinical outcomes after ICH, and assess the effect of tranexamic acid on ultra-early HE. Methods: We performed a planned secondary analysis of the STOP-MSU international multicenter randomized controlled trial. Repeat CT imaging ~1 hour after treatment commencement was encouraged. Patients who underwent re-imaging up to 3 hours from baseline imaging were included in this descriptive study. Hematoma expansion was defined as either a ≥33% or ≥6 ml increase from baseline hematoma volume. Results: We included 105 patients who had 1-hour imaging (median age 66years, 40% female, 53% tranexamic acid). Median time from onset to baseline imaging was 74min (IQR 56-
