It is well documented that the existence of hematoma expansion is a potent sign for poor prognosis of patients with intracranial hemorrhage (ICH). Current clinical studies have already revealed the effectiveness of spot sign in predicting early hematoma expansion, as well as the functional outcome of ICH patients . However, due to inadequate equipment and supplies at emergency unit and walk-in clinic in some developing countries, spot sign screening could not be performed at early stages of initial ictus (within 24 hours) by using computed tomography angiography (CTA) in many cases. Nevertheless, island sign from NonContract Computed Tomography (NCCT) is widely used and relatively easier to be obtained at pre-admission period in many developing countries, including China. Island sign is one of the most commonly observed NCCT sign in China and in literature regarding early NCCT hematoma expansion signs. Despite the fact that island sign is a well-established hematoma expansion predictor, limited studies has focused on the comparison of this neuroradiological feature with spot sign, as well as its potential predictive value in the prognosis of patients with ICH.