Purpose

Intracerebral hemorrhage (ICH) accounts for up to 20% of all strokes, and there is a high rate of associated morbidity and mortality. Computed tomography (CT) findings, such as a spot sign have been shown to be an independent predictor of poor outcome. We have recently encountered a succession of ICH patients who presented with a peculiar imaging finding, which we term the spot on a string sign. This is a rare imaging finding, and interestingly, all these patients presented to our institution over the last few weeks.

Methods

This was a single high-volume center series of patients who presented to our institution between 1 April and 21 May 2020. All patients underwent initial non-contrast CT brain and subsequent CT angiography (CTA). We also present laboratory and clinical data. Our primary measure was the presence of the spot on a string sign on the CTA. We also report the clinical course of these patients.

Results

In this study seven large-volume ICH patients with this imaging sign were identified, with a median age of 48 years (range 30–68 years). All had tested negative for coronavirus disease 19 (COVID-19).

Conclusion

We have described an unusual imaging finding in a cohort of younger patients with large-volume ICH, all of whom presented in a 2-month period to a high-volume neurovascular unit. The cause of these ICH presentations and associated imaging findings are unclear, but we encourage other clinicians to be aware of and vigilant for this rare phenomenon, especially in younger patients with such a bleeding pattern.

中文翻译：

---

不是细绳，不是缠结，也不是动脉瘤：与影像学异常血管相关的年轻患者出现大实质出血的新模式。

目的

脑出血 (ICH) 占所有中风的 20%，并且相关的发病率和死亡率很高。计算机断层扫描 (CT) 发现，例如点征，已被证明是预后不良的独立预测因素。我们最近遇到了一系列 ICH 患者，他们表现出特殊的影像学表现，我们将其称为字符串标志上的点。这是一个罕见的影像学发现，有趣的是，所有这些患者都是在过去几周内就诊于我们机构的。

方法

这是 2020 年 4 月 1 日至 5 月 21 日期间就诊于我们机构的单个高容量中心系列患者。所有患者均接受了初始非对比 CT 脑部和随后的 CT 血管造影 (CTA)。我们还提供实验室和临床数据。我们的主要衡量标准是在 CTA 上的字符串标志上是否存在该点。我们还报告了这些患者的临床病程。

结果

在这项研究中，确定了 7 名具有这种影像学征象的大体积 ICH 患者，中位年龄为 48 岁（范围 30-68 岁）。所有人的冠状病毒病 19 (COVID-19) 检测均呈阴性。

结论

我们描述了一组年轻的大容量 ICH 患者的不寻常的影像学发现，所有这些患者都在 2 个月内就诊于大容量神经血管单元。这些 ICH 表现的原因和相关的影像学表现尚不清楚，但我们鼓励其他临床医生注意并警惕这种罕见现象，尤其是在出现这种出血模式的年轻患者中。