- Traumatic Intracranial Hematomas: Prognostic Value of Contrast Extravasation
Contrast extravasation in hematomas predicts their growth and thus these authors assessed the prognostic value of this sign. Sixty patients with cerebral hematomas received CTA and/or perfusion CT within 24 hours of admission and then a follow-up CT at 72 hours. Fifty percent of patients showed contrast extravasation and this finding predicted poor in-hospital outcome. Recognition of contrast extravasation achieved a near perfect interobserver agreement.
- Clopidogrel Hyper-Response and Bleeding Risk in Neurointerventional Procedures
Patients may respond to antiplatelet medication in 2 ways: resistance leading to higher incidence of ischemic events and hyper-response resulting in bleeds. Here, 47 patients treated with clopidogrel were tested for P2Y12 receptor-mediated platelet inhibition. Clopidogrel hyper-response was more common in patients with major (n=10) than in those with minor bleeds. Of 7 patients defined as hyper-responders, 43% had major bleeding complications. Thus, hyper-response to clopidogrel is associated with increased risk of major hemorrhage. (See the related article by Comin and Kallmes.)
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