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Contrast extravasation in hematomas predicts their growth and thus these authors assessed the prognostic value of this sign. Sixty patients with cerebral hematomas received CTA and/or perfusion CT within 24 hours of admission and then a follow-up CT at 72 hours. Fifty percent of patients showed contrast extravasation and this finding predicted poor in-hospital outcome. Recognition of contrast extravasation achieved a near perfect interobserver agreement.