Sensitivity and specificity of fluid-blood levels for coagulopathy in acute intracerebral hematomas

Journal Article · Tue Feb 01 00:00:00 EST 1994 · AJNR. American Journal of Neuroradiology; (United States)

OSTI ID:6481987

Pfleger, M J; Hardee, E P; Hayman, L A; Contant, Jr, C F ^[1]

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1. Baylor College of Medicine, Houston, TX (United States)

To characterize the imaging features of intracerebral hemorrhages in patients with coagulopathies that alter prothrombin time or partial thromboplastin time. A fluid-blood level was defined as a horizontal interface between hypodense bloody serum layered above hyperdense settled blood. The prevalence of fluid-blood levels in acute intracerebral hemorrhages was determined on third-generation CT scans in 32 patients with elevation in prothrombin time or partial thromboplastin time. This was compared with the frequency of fluid-blood levels in 185 patients with intracerebral hemorrhage in which there was no laboratory evidence of coagulopathy. The probability of finding a fluid-blood level in an intracerebral hemorrhage of a patient with abnormal prothrombin time or partial thromboplastin time was 59% (sensitivity). The probability that there will be no fluid-blood level in a patient with a normal prothrombin time and partial thromboplastin time was 98% (specificity). Fluid-blood levels in acute intracerebral hemorrhage are moderately sensitive to the presence of coagulopathy (i.e., abnormal prothrombin time and partial thromboplastin time) and highly specific for this condition. Thus, an intracerebral hemorrhage with a fluid-blood level should prompt a thorough search for coagulopathy because early treatment of this condition may improve the 40% mortality in these patients. Caution should be used to distinguish the horizontal interface of a fluid-blood level from a clot with a flat top. A decubitus CT is useful in these rare instances. 20 refs., 5 figs., 2 tabs.

• OSTI ID: 6481987
• Journal Information: AJNR. American Journal of Neuroradiology; (United States), Vol. 15:2; ISSN 0195-6108
• Country of Publication: United States
• Language: English

Related Subjects

59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
ANTICOAGULANTS
RESPONSE MODIFYING FACTORS
BLOOD COAGULATION
COMPUTERIZED TOMOGRAPHY
BRAIN
HEMORRHAGE
BLOOD
HEMATOMAS
PROTHROMBIN
THROMBOPLASTIN
BIOLOGICAL MATERIALS
BLOOD COAGULATION FACTORS
BODY
BODY FLUIDS
CENTRAL NERVOUS SYSTEM
COAGULANTS
DIAGNOSTIC TECHNIQUES
DRUGS
HEMATOLOGIC AGENTS
HEMOSTATICS
MATERIALS
NERVOUS SYSTEM
ORGANIC COMPOUNDS
ORGANS
PATHOLOGICAL CHANGES
PROTEINS
SYMPTOMS
TOMOGRAPHY
550900* - Pathology
550602 - Medicine- External Radiation in Diagnostics- (1980-)