Black hole sign (intracerebral hemorrhage)
Citation, DOI, disclosures and article data
At the time the article was created Khalid Alhusseiny had no recorded disclosures.
View Khalid Alhusseiny's current disclosuresAt the time the article was last revised Frank Gaillard had the following disclosures:
- Radiopaedia Australia Pty Ltd and Radiopaedia Events Pty Ltd, Director, Founder and CEO (Radiopaedia) (ongoing)
- Biogen Australia Pty Ltd, Investigator-Initiated Research Grant for CAD software in multiple sclerosis: finished Oct 2021 (past)
These were assessed during peer review and were determined to not be relevant to the changes that were made.
View Frank Gaillard's current disclosures- CT black hole sign
The black hole sign refers to the non-contrast CT appearance of acute extravasation of blood into a hematoma, for example, an intracerebral hemorrhage, and therefore is a predictor of hemorrhage expansion 3. It can be thought of as an encapsulated swirl sign.
Radiographic features
The black hole sign represents a well-defined hypodense region within a hyperdense hematoma that is not connected to the nearby brain parenchyma 1,3. It may have variable shapes (round, oval, rod-like).
There should be at least a 28 Hounsfield unit (HU) difference between the black hole and the surrounding hemorrhage 1,3.
References
- 1. Li Q, Zhang G, Xiong X et al. Black Hole Sign. Stroke. 2016;47(7):1777-81. doi:10.1161/strokeaha.116.013186
- 2. Shakya M, Fu F, Zhang M et al. Comparison of Black Hole Sign, Satellite Sign, and Iodine Sign to Predict Hematoma Expansion in Patients with Spontaneous Intracerebral Hemorrhage. BioMed Research International. 2021;2021:1-8. doi:https://doi.org/10.1155/2021/3919710
- 3. Morotti A, Boulouis G, Dowlatshahi D et al. Standards for Detecting, Interpreting, and Reporting Noncontrast Computed Tomographic Markers of Intracerebral Hemorrhage Expansion. Ann Neurol. 2019;86(4):480-92. doi:10.1002/ana.25563 - Pubmed
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