CT angiography "spot sign"

Patient with spot sign, demonstrating extravasation and hematoma expansion. CT slice selection has been optimized for hematoma configuration, not for head position.
(A) Unenhanced CT demonstrates left posterior putaminal and internal capsule hematoma with mild surrounding edema. An old parieto-occipital infarct is seen posterior to this.
(B) A small focus of enhancement is seen peripherally on CTA source images, consistent with the spot sign (arrow).
(C) Post-contrast CT demonstrates enlargement of the spot sign, consistent with extravasation (thick arrow).
(D) Unenhanced CT image one day after presentation reveals hematoma enlargement and intraventricular hemorrhage.