Koji Tanaka, Umberto Pensato, Mohamed Alshamrani, Aristeidis H Katsanos, Pargol Balali, Sucharita Ray, Scott E Kasner, Jan Beyer-Westendorf, Danilo Toni, David J Seiffge, Carlos Molina, David Tanne, Anna Członkowska, Arne G Lindgren, Daniel Bereczki, Else C Sandset, Georgios Tsivgoulis, Hanne Christensen, Jonathan M Coutinho, Peter Verhamme, Pierre Amarenco, Robin Lemmens, Roland Veltkamp, Saskia Middeldorp, Thompson Robinson, Truman J Milling, Wilfried Lang, Vitor Tedium-Cruz, Mark Crowther, Lizhen Xu, Mikael Knutsson, Per Ladenvall, John W Eikelboom, Mukul Sharma, Ashkan Shoamanesh, Andrew M Demchuk
In this post hoc analysis of the ANNEXa-I trial (n = 434), we evaluated non-contrast computed tomography (NCCT) markers of hematoma expansion (HE) in factor Xa inhibitor (FXai) -associated intracerebral hemorrhage (ICH). At least one NCCT marker was present in 72.1%, and HE (≥12.5 mL or ≥ 35% increase in hematoma volume) occurred in 31.8%. Heterogeneous density, hypodensity, and the black hole sign were independently associated with HE. The effect of andexanet on HE was generally consistent across NCCT marker subgroups. These findings support the utility of NCCT markers for identifying patients at high risk of HE in FXai-associated ICH. ANN NEUROL 2026.