The irregular sign, black hole sign, blend sign and early use of dehydration may be the main risk factors for hematoma expansion group, whereas early use of dehydration, high systolic blood pressure, and low-density band may be the main risk factors for hematoma expansion 1).

Compared with previously reported predictors for hematoma expansion on non-enhanced CT, such as blend sign, black hole sign and heterogeneous density, CTA spot sign has better predictive accuracy for hematoma expansion 2) 3) 4).

1)
Wei L, Lin C, Zhou Z, Zhang J, Tan Q, Zhang Y, Zhang B, Ye D, Wu L, Liu Q, Xian J, Chen Z, Feng H, Zhu G. Analysis of different hematoma expansion shapes caused by different risk factors in patients with hypertensive intracerebral hemorrhage. Clin Neurol Neurosurg. 2020 Apr 12;194:105820. doi: 10.1016/j.clineuro.2020.105820. [Epub ahead of print] PubMed PMID: 32315941.
2)
Blacquiere D, Demchuk AM, Al-Hazzaa M, Deshpande A, Petrcich W, Aviv RI, Rodriguez-Luna D, Molina CA, Silva Blas Y, Dzialowski I, Czlonkowska A, Boulanger JM, Lum C, Gubitz G, Padma V, Roy J, Kase CS, Bhatia R, Hill MD, Dowlatshahi D; PREDICT/Sunnybrook ICH CTA Study Group. Intracerebral Hematoma Morphologic Appearance on Noncontrast Computed Tomography Predicts Significant Hematoma Expansion. Stroke. 2015 Nov;46(11):3111-6. doi: 10.1161/STROKEAHA.115.010566. Epub 2015 Oct 8. PubMed PMID: 26451019.
3)
Zheng J, Yu Z, Xu Z, Li M, Wang X, Lin S, Li H, You C. The Accuracy of the Spot Sign and the Blend Sign for Predicting Hematoma Expansion in Patients with Spontaneous Intracerebral Hemorrhage. Med Sci Monit. 2017 May 12;23:2250-2257. PubMed PMID: 28498827; PubMed Central PMCID: PMC5437917.
4)
Yu Z, Zheng J, Ma L, Guo R, Li M, Wang X, Lin S, Li H, You C. The predictive accuracy of the black hole sign and the spot sign for hematoma expansion in patients with spontaneous intracerebral hemorrhage. Neurol Sci. 2017 Jun 2. doi: 10.1007/s10072-017-3006-6. [Epub ahead of print] PubMed PMID: 28577268.