Abstract
Introduction: Intracerebral hemorrhage (ICH) is the second most common cause of stroke, trailing only ischemic stroke in frequency. This study aimed at describing and understanding the demographic and clinical profile of patients with non-traumatic ICH presenting to our centre.
Methodology: We did a hospital based observational study in the Department of Medicine, MVP’s Dr.Vasantrao Pawar Medical College Hospital and Research Centre Adagaon, Nashik from May 2012 till December 2014 of 50 consecutive patients diagnosed with non-traumatic intracranial bleed. We obtained detailed history of the patients and findings of general, systemic and neurological examinations. Routine investigations were sent along with CT head and in some cases special investigations were sent. All patients were re-evaluated at the time of discharge to assess the prognosis and clinical outcome of patients. Descrptive analysis was performed using means and percentages. Statistical analysis was done to look for associations of site of hematoma with symptoms observed.
Results: Average age of the patients was 60.86±11.08 years, 62% of the population were males. 58% of the population had mean arterial pressure of less than equal to 140 mm Hg and had GCS of more than 9, 34% had scores more than 20. Headache was seen to be the most common symptom observed. Radiologically, more than 30cc of hematoma was seen in 66% of the patients and midline shift was observed in 38% of the patients.
Conclusions: Clinico-demographic variables of the patient can help us in assess the prognostic outcome in such patients.
Keywords: stroke, hemorrhage, outcome, complications, symptoms, mortality.
References
- Broderick JP, Brott T, Tomsick T, et al. Intracerebral hemorrhage more than twice as common as subarachnoid hemorrhage. J Neurosurg 1993; 78:188.
- Sacco S, Marini C, Toni D, et al. Incidence and 10-year survival of intracerebral hemorrhage in a population-based registry. Stroke 2009; 40:394.
- van Asch CJ, Velthuis BK, Greving JP, et al. External validation of the secondary intracerebral hemorrhage score in The Netherlands. Stroke 2013; 44:2904.
- Beslow LA, Licht DJ, Smith SE, et al. Predictors of outcome in childhood intracerebral hemorrhage: a prospective consecutive cohort study. Stroke 2010; 41:313.
- Broderick J, Connolly S, Feldmann E, et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group. Stroke 2007; 38:2001.
- Kimura Y, Takishita S, Muratani H, et al. Demographic study of first-ever stroke and acute myocardial infarction in Okinawa, Japan. Intern Med 1998; 37:736.
- Thrift AG, McNeil JJ, Forbes A, Donnan GA. Three important subgroups of hypertensive persons at greater risk of intracerebral hemorrhage. Melbourne Risk Factor Study Group. Hypertension 1998; 31:1223.
- Jackson CA, Sudlow CL. Is hypertension a more frequent risk factor for deep than for lobar supratentorial intracerebral haemorrhage? J NeurolNeurosurg Psychiatry 2006; 77:1244.
- Flaherty ML, Tao H, Haverbusch M, et al. Warfarin use leads to larger intracerebral hematomas. Neurology 2008; 71:1084.
- Claassen J, Jetté N, Chum F, et al. Electrographic seizures and periodic discharges after intracerebral hemorrhage. Neurology 2007; 69:1356.
- Vespa PM, O'Phelan K, Shah M, et al. Acute seizures after intracerebral hemorrhage: a factor in progressive midline shift and outcome. Neurology 2003; 60:1441.
- Cheung RT, Zou LY. Use of the original, modified, or new intracerebral hemorrhage score to predict mortality and morbidity after intracerebral hemorrhage. Stroke. 2003 Jul 1;34(7):1717-22.
- Martini SR, Flaherty ML, Brown WM, Haverbusch M, Comeau ME, Sauerbeck LR, Kissela BM, Deka R, Kleindorfer DO, Moomaw CJ, Broderick JP. Risk factors for intracerebral hemorrhage differ according to hemorrhage location. Neurology. 2012 Dec 4;79(23):2275-82.
- Kidwell CS, Wintermark M. Imaging of intracranial haemorrhage. Lancet Neurol 2008; 7:256.
Corresponding Author
Dr Rathod Rahul Narayanrao
Assistant Professor, Department of Medicine, BJ Medical College and Sassoon General Hospitals,
Jai Prakash Narayan Road, Near Pune Railway Station, Pune – 411001
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.99
