The extravasation of contrast as a predictor of cerebral hemorrhagic contusion expansion, poor neurological outcome and mortality after traumatic brain injury: A systematic review and meta-analysis
Baldon, Isabella Vargas
Amorim, Andre Candeas
Santana, Larissa Marques
Paiva, Wellingson S.
Public Library of Science
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Baldon, I. V., Amorim, A. C., Santana, L. M., Solla, D. J., Kolias, A., Hutchinson, P., Paiva, W. S., & et al. (2020). The extravasation of contrast as a predictor of cerebral hemorrhagic contusion expansion, poor neurological outcome and mortality after traumatic brain injury: A systematic review and meta-analysis. PLOS ONE, 15 (7)https://doi.org/10.1371/journal.pone.0235561
Background: The active extravasation of contrast on CT angiography (CTA) in primary intracerebral hemorrhages (ICH) is recognized as a predictive factor for ICH expansion, unfavorable outcomes and mortality. However, few studies have been conducted on the setting of traumatic brain injury (TBI). Purpose: To perform a literature systematic review and meta-analysis of the association of contrast extravasation on cerebral hemorrhagic contusion expansion, neurological outcomes and mortality. Data sources: The PubMed, Cochrane Library, Medline, Scielo, VHL and IBECS databases up to September 21, 2019, were searched for eligible studies. Study selection: A total of 505 individual titles and abstracts were identified and screened. A total of 36 were selected for full text analysis, out of which 4 fulfilled all inclusion and exclusion criteria. Data analysis: All 4 studies yielded point estimates suggestive of higher risk for hematoma expansion with contrast extravasation and the summary RR was 5.75 (95%CI 2.74–10.47, p<0.001). Contrast extravasation was also associated with worse neurological outcomes (RR 3.25, 95%CI 2.24–4.73, p<0.001) and higher mortality (RR 2.77, 95%CI 1.03–7.47, p = 0.04). Data synthesis: This study is a Systematic Review and Meta-Analysis revealed the extravasation of contrast is a useful imaging sign to predict hematoma expansion, worse neurological outcomes and higher mortality. Limitations: Only four articles were selected. Conclusions: The extravasation of contrast in the setting of TBI is a useful imaging sign to predict hematoma expansion, worse neurological outcomes and higher mortality.
Research Article, Research and analysis methods, Biology and life sciences, Medicine and health sciences, Physical sciences
External DOI: https://doi.org/10.1371/journal.pone.0235561
This record's URL: https://www.repository.cam.ac.uk/handle/1810/307722