Performance Measurement Network

Question: Positive Brain Image

Patient received IV TPA on 4/26 (admit date. Subsequent MRI on 4/27 stated "very minimal petechial hemorrhage demonstrated at the surface of right parietl lobe on series 7 image 18." However, progress note dated 4/28 and subsequent progress notes/discharge summary state "repeat CT showed dissipation of enhancement indicating contrast rather than hemorrhage." Would I answer "yes" or "no" to Positive Brain Image?)

Answer:

Select 'YES' for"Positive Brain Image" because a hemorrhage, although small, was noted on brain imaging post thrombolysis. To put the case in the numerator, clinical deterioration greater than or equal to a 4 point increase NIHSS score is also needed. Hemorrhage without clinical deterioration is not considered hemorrhagic transformation. Hope this clarifies for you. Thank you for your inquriy.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: CSTK, Positive Brain Image,
Manual: Current Manual (current data collection period; prior to data transmission)

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