Spontaneous intracerebral hemorrhage (ICH) has a high rate of morbidity and mortality. One of the predictors of poor outcome is hematoma expansion, defined as a 30% or 6-mL increase in hematoma volume after follow-up neuroimaging. A simple algorithm, BRAIN (Baseline ICH volume, Recurrent ICH, Anticoagulation with warfarin, Intraventricular extension, and Number of hours to baseline computed tomography from symptom onset), a 24-point score that predicts the probability of hematoma expansion within 24 hours has been developed. This study aimed to validate BRAIN scoring in prediction of hematoma expansion in ICH patients. A prospective, external validation study consisting of 100 ICH from August 2015 to March 2017 was done. Subjects underwent initial cranial CT scan and BRAIN score was determined. Repeat neuroimaging was done after 24 hours. The volume of hemorrhage on the initial and repeat CT scan were computed. The validity of BRAIN scores to predict an increase in the hematoma volume was calculated utilizing the ROC curve. Results showed that the BRAIN score of 8 was discriminative in predicting hematoma expansion in ICH patients (area under the curve, 0.8722) and calibration (Hosmer–Lemeshow P=0.80) with a sensitivity and specificity of 82% and 72%. The BRAIN score is a simple and reliable in predicting hematoma expansion in ICH patients. It could be helpful in risk stratification and prognostication of intracerebral hemorrhage patients.

ASSESSING CLINICAL OUTCOME USING BRAIN SCORE AS A PREDICTOR OF HEMATOMA GROWTH IN ACUTE SPONTANEOUS INTRACEREBRAL HEMORRHAGE PATIENTS