Editors' note: Blood pressure reduction and noncontrast CT markers of intracerebral hemorrhage expansion

In “Blood pressure reduction and noncontrast CT markers of intracerebral hemorrhage expansion,” authors Morotti et al. found that noncontrast CT (NCCT) signs such as intrahematoma hypodensities, black hole sign, swirl sign, blend sign, heterogeneous hematoma density, and irregular shape reliably identify intracerebral hemorrhage (ICH) patients at high risk of hematoma growth. However, they did not find benefit from intensive BP reduction. Commenting on the paper, Ye et al. shared their own experience in patients with ICH undergoing surgical treatment. In contrast to Morotti et al., they found that intensive BP reduced the 3-month mortality in patients with blend sign. Morotti et al. ask whether this association is mediated by a reduced risk of hematoma expansion or rehemorrhage after surgery. They suggest prospective studies on a larger sample size could influence the indication and timing of surgery in ICH patients with specific NCCT signs. In “Blood pressure reduction and noncontrast CT markers of intracerebral hemorrhage expansion,” authors Morotti et al. found that noncontrast CT (NCCT) signs such as intrahematoma hypodensities, black hole sign, swirl sign, blend sign, heterogeneous hematoma density, and irregular shape reliably identify intracerebral hemorrhage (ICH) patients at high risk of hematoma growth.