The accuracy of non-contrast brain CT scan in predicting the presence of a vascular etiology in patients with primary intracranial hemorrhage

Abstract

Abstract Introduction: Spontaneous intraparenchymal cerebral hemorrhages (SIPH) account for 10-15% of cases of acute stroke. stratification of these patients according to the risk of harboring an underlying vascular etiology would help for selecting the patients who mostly benefit from multidetector CT angiography (MDCTA). The aim of this study was to Evaluate the accuracy of non-contrast brain CT (NCCT) in predicting the presence of a vascular etiology in patients with SIPH. Materials and Methods: In this retrospective study, we used NCCT criteria to predict the presence of vascular etiology in SIPH patients. Results: Of the 385 evaluated patients, 21.3% had an underlying vascular etiology. Independent predictors of the vascular etiology included age< 50 years, no history of hypertension and coagulation disorder, lobar hemorrhage, concurrent IVH or SAH, and significant perilesional edema. We used the independent predictors of vascular etiology and NCCT classification to create a practical scoring system to predict the risk of vascular ICH (VICH). VICH score ≤4 had 76.8% Sensitivity and 90.1% Specificity for prediction of a positive MDCTA. Conclusion: The VICH score was successful in the prediction of vascular etiology in this retrospective cohort of 385 patients.