BAT versus BRAIN Score for Prediction of Hematoma Expansion in Spontaneous Intracerebral Hemorrhage: A Prospective Observational Study

Background: Spontaneous intracerebral haemorrhage (ICH) is a major cause of mortality and morbidity globally, with hematoma expansion (HE) being a key predictor of poor outcomes. Identifying patients at high risk for HE is crucial to initiate timely interventions. The BRAIN and BAT scores are two scoring systems that predict HE, but their comparative effectiveness remains unclear. Objective: This study aimed to evaluate and compare the predictability of hematoma expansion using the BRAIN and BAT scores in patients with spontaneous parenchymal ICH. Methods: A cross-sectional observational study was conducted at the Department of Neurology, Government Medical College, Kota, from October 2023 to October 2024. A total of 90 patients with spontaneous parenchymal ICH who underwent a non-contrast CT (NCCT) head scan within 6 hours of symptom onset and a follow-up CT at 24 hours were included. Hematoma volume was calculated, and BRAIN and BAT scores were assessed. The relationship between hematoma expansion, clinical parameters, and imaging markers such as blend sign and hypodensities was analysed. Results: Hematoma expansion occurred in 33 of 90 patients (36.7%), with a higher mean BAT score (2.15 ± 1.48) in patients with HE compared to those without (0.11 ± 0.32, p