Swirl sign (intracranial hemorrhage) | 合法醫療器材資訊網

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The swirl sign refers to the non-contrast CT appearance of acute extravasation of blood into a hematoma, for example an intracerebral hemorrhage[1], extradural hematoma[2] or subdural hematoma[3]. It represents unclotted fresh blood which is of lower attenuation than the clotted blood which surrounds it 1,5,6. It is in some ways the corollary of the spot sign[4] on CTA which represents the same phenomenon, but in that case, caused by extraluminal focal accumulation/pooling/extravasation of contrast 2,5.

In an intracerebral hemorrhage[5], the swirl sign is one of many predictors of hematoma expansion 5 (see intracerebral hemorrhage[6] for further discussion).

The swirl sign is only one of many imaging features described in an attempt to predict hematoma growth, and in many instances, these signs overlap. 

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