Blend sign

David Goldemund M.D.
Updated on 21/04/2024, published on 25/02/2023

early hematoma growth is observed in approximately one-third of the patients with spontaneous intracerebral hemorrhage (ICH)
the blend sign (BS) on baseline non-contrast computed tomography (NCCT) is a marker of increased risk of hemorrhage progression and a predictor of poor outcomes in patients with ICH [Li, 2017] (Schreiber, 2023)
- blend sign is not associated with poor outcomes in patients with hypertensive ICH after stereotactic minimally invasive surgery (sMIS) (Yang, 2021)
the blend sign has a good correlation with the spot sign, the latter being more sensitive and reliable, but it requires the administration of a contrast agent [Sporns, 2017]
blend sign and black hole sign can help predict outcome when CT angiography is unavailable

Blend sign specifications

a mix of hyperdense and relatively hypodense areas (difference > 18 HU)
easily distinguishable by eye
sharply demarcated from each other
the hypodense area is not completely surrounded by the hyperdense area

Blend sign - a mix of hyperdense and relatively hypodense areas (difference > 18 HU) easily distinguishable by eye

Blend sign

Blend sign (baseline and 3hr later)

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Blend Sign
link: https://www.stroke-manual.com/blend-sign/