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Bold-S Signs on Computed Tomography Angiography Are Sensitive Markers for Diagnosing Subcortical Hemorrhage Due to Dural Arteriovenous Fistulae on Emergent Admission
An optimal treatment strategy for subcortical hematomas caused by dural arteriovenous fistulae (dAVF) is important because of the high rebleeding rate. However, it is very difficult to diagnose that on admission. Therefore, an early sensitive predictive marker for subcortical hemorrhage caused by dA...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japan Neurosurgical Society
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072889/ https://www.ncbi.nlm.nih.gov/pubmed/36599432 http://dx.doi.org/10.2176/jns-nmc.2022-0256 |
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author | OHKUBO, Taku KAJIWARA, Sosho HASEGAWA, Yu HASHIMOTO, Aya TAKEUCHI, Yasuharu ORITO, Kimihiko KAWANO, Takayuki FUJIMORI, Kana SAKATA, Kiyohiko HIROHATA, Masaru MORIOKA, Motohiro |
author_facet | OHKUBO, Taku KAJIWARA, Sosho HASEGAWA, Yu HASHIMOTO, Aya TAKEUCHI, Yasuharu ORITO, Kimihiko KAWANO, Takayuki FUJIMORI, Kana SAKATA, Kiyohiko HIROHATA, Masaru MORIOKA, Motohiro |
author_sort | OHKUBO, Taku |
collection | PubMed |
description | An optimal treatment strategy for subcortical hematomas caused by dural arteriovenous fistulae (dAVF) is important because of the high rebleeding rate. However, it is very difficult to diagnose that on admission. Therefore, an early sensitive predictive marker for subcortical hemorrhage caused by dAVF is necessary, especially during the first contact on admission. S-shaped dilated vessels around the hematoma (bold-S sign) on computed tomography angiography (CTA) performed during admission could be one such marker. Herein, we evaluated the characteristics of these vessels. Among 273 patients with intracerebral hemorrhage between April 2012 and March 2020, 67 patients with subcortical hematomas who underwent CTA on admission without arteriovenous malformations were included. The patients in the dAVF group (n = 7) showed fewer disturbances in consciousness, milder neurological deficits, and more frequent seizures than patients without dAVF (without dAVF group, n = 60). All patients in the dAVF group had dilated S-shaped vessels (2.59 ± 0.27 mm) around the hematomas, and only 20% of the patients in the without dAVF group had these vessels (1.69 ± 0.22 mm). The ratio of the ipsilateral S-shaped/contralateral largest vessels was 1.80 ± 0.29 in the dAVF group and 1.07 ± 0.16 in the group without dAVF. We called the dilated S-shaped vessels the “bold-S sign,” with a cutoff ratio of 1.5. Bold-S sign findings are novel and help in diagnosing subcortical hematomas caused by dAVF on admission. |
format | Online Article Text |
id | pubmed-10072889 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Japan Neurosurgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-100728892023-04-05 Bold-S Signs on Computed Tomography Angiography Are Sensitive Markers for Diagnosing Subcortical Hemorrhage Due to Dural Arteriovenous Fistulae on Emergent Admission OHKUBO, Taku KAJIWARA, Sosho HASEGAWA, Yu HASHIMOTO, Aya TAKEUCHI, Yasuharu ORITO, Kimihiko KAWANO, Takayuki FUJIMORI, Kana SAKATA, Kiyohiko HIROHATA, Masaru MORIOKA, Motohiro Neurol Med Chir (Tokyo) Original Article An optimal treatment strategy for subcortical hematomas caused by dural arteriovenous fistulae (dAVF) is important because of the high rebleeding rate. However, it is very difficult to diagnose that on admission. Therefore, an early sensitive predictive marker for subcortical hemorrhage caused by dAVF is necessary, especially during the first contact on admission. S-shaped dilated vessels around the hematoma (bold-S sign) on computed tomography angiography (CTA) performed during admission could be one such marker. Herein, we evaluated the characteristics of these vessels. Among 273 patients with intracerebral hemorrhage between April 2012 and March 2020, 67 patients with subcortical hematomas who underwent CTA on admission without arteriovenous malformations were included. The patients in the dAVF group (n = 7) showed fewer disturbances in consciousness, milder neurological deficits, and more frequent seizures than patients without dAVF (without dAVF group, n = 60). All patients in the dAVF group had dilated S-shaped vessels (2.59 ± 0.27 mm) around the hematomas, and only 20% of the patients in the without dAVF group had these vessels (1.69 ± 0.22 mm). The ratio of the ipsilateral S-shaped/contralateral largest vessels was 1.80 ± 0.29 in the dAVF group and 1.07 ± 0.16 in the group without dAVF. We called the dilated S-shaped vessels the “bold-S sign,” with a cutoff ratio of 1.5. Bold-S sign findings are novel and help in diagnosing subcortical hematomas caused by dAVF on admission. The Japan Neurosurgical Society 2023-01-05 /pmc/articles/PMC10072889/ /pubmed/36599432 http://dx.doi.org/10.2176/jns-nmc.2022-0256 Text en © 2023 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License. |
spellingShingle | Original Article OHKUBO, Taku KAJIWARA, Sosho HASEGAWA, Yu HASHIMOTO, Aya TAKEUCHI, Yasuharu ORITO, Kimihiko KAWANO, Takayuki FUJIMORI, Kana SAKATA, Kiyohiko HIROHATA, Masaru MORIOKA, Motohiro Bold-S Signs on Computed Tomography Angiography Are Sensitive Markers for Diagnosing Subcortical Hemorrhage Due to Dural Arteriovenous Fistulae on Emergent Admission |
title | Bold-S Signs on Computed Tomography Angiography Are Sensitive Markers for Diagnosing Subcortical Hemorrhage Due to Dural Arteriovenous Fistulae on Emergent Admission |
title_full | Bold-S Signs on Computed Tomography Angiography Are Sensitive Markers for Diagnosing Subcortical Hemorrhage Due to Dural Arteriovenous Fistulae on Emergent Admission |
title_fullStr | Bold-S Signs on Computed Tomography Angiography Are Sensitive Markers for Diagnosing Subcortical Hemorrhage Due to Dural Arteriovenous Fistulae on Emergent Admission |
title_full_unstemmed | Bold-S Signs on Computed Tomography Angiography Are Sensitive Markers for Diagnosing Subcortical Hemorrhage Due to Dural Arteriovenous Fistulae on Emergent Admission |
title_short | Bold-S Signs on Computed Tomography Angiography Are Sensitive Markers for Diagnosing Subcortical Hemorrhage Due to Dural Arteriovenous Fistulae on Emergent Admission |
title_sort | bold-s signs on computed tomography angiography are sensitive markers for diagnosing subcortical hemorrhage due to dural arteriovenous fistulae on emergent admission |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072889/ https://www.ncbi.nlm.nih.gov/pubmed/36599432 http://dx.doi.org/10.2176/jns-nmc.2022-0256 |
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