Clinico-Epidemiological Profile of Intracerebral Hemorrhage
Keywords:
Intrecerebral Hemorrhage, ICH, Consciousness, Glasgow Coma scale, blood pressure, MAPAbstract
Introduction: Clinico-epidemiological spectrum plays key role in provisional diagnosis and prognosis of Intracerebral Hemorrhage (ICH). The objectives of this study were to evaluateclinico-epidemiological profile and to identify and analyze clinical determinants of In-hospital mortality.
Material and Methods: All patients (n=211), aged more than 12 years, diagnosed with ICH (based on CT scan/MRI) were studied for demographic profile, clinical profile, Glasgow Coma Scale (GCS) on admission and outcome.
Results: ICH was more common in >60 yr age group (52.13%). Mean Age (±SD) is 62.04 (±15.16). M: F ratio is 1.15:1. Its incidence increased during the winter season (53.55%) from the months of November to February and early morning hours (61.14%). Weakness (69.67%) and Loss of consciousness (LOC) /altered sensorium (59.72%) were the two most common presenting complaints on admission. In-Hospital mortality was 87(41.23%) with maximum mortality occurring within 72 hours.
Conclusion: In-hospital clinical mortality determinants of ICH on admission were: Loss of consciousness (LOC)/altered sensorium, headache, vomiting, addiction, tobacco, smoking, hyperglycemia, MAP >120, and GCS ≤ 8.
References
Cerebrovascular diseases. In : Allan H. Ropper,Martin A. Samuels,Joshua P. Klein, Eds. Adams and Victor’s Principle of Neurology.10th edition. McGraw Hill education. Newyork; 2014: 778-884.
Stephan A. Mayer.Hemorrhagic cerebrovascular disease. In: Lee goldman, Andrew I. Schafer,Eds. Goldman-Cecil medi-cine. 25th edition. Volume 2. Elsevier India; 2016:2445-2453.
Wade S Smith, S. Claiborne Johnston, J. Claude Hemphill, Ill. Cerebrovascular diseases. In : Dennis L. Kasper, Antho-ny S. Fauci, Stephen L. Hauser, Dan L. Longo, J. Larry Jame-son, Joseph loscalzo, Eds. Harrison’s principles of Internal Medicine . 19th edition. Volume 2. McGraw Hill Education Newyork; 2015:2559-2585.
Carlos S. Kase.Vascular disease of the nervous system - In-tracerebral haemorrhage. In: Walter G. Bradley, Robert B. Daroff,Gerald M. Fenichel, Joseph Jankovic,Eds. Neurology in Clinical Practice. 5th edition. Volume 2. Butterworth Heinemann Elsevier Philadelphia; 2008:1225-1241.
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; 38:2001-23.
Sahni R, Weinberger J. Management of intracerebral hemor-rhage. Vasc. Health Risk Manag. 2007; 3(5):701-9.
Charles Warlow. Stroke, transient ischaemic attacks and intracranial venous thrombosis. In: Michael Donaghy, Ed. Brain’s diseases of the nervous system. 11th edition. Oxford University Press. Newyork; 2001: 775-896.
Daverat P, Castel JP, Dartigues JF and Orgogozo JM.Death and functional outcome after spontaneous intracerebral hemorrhage A prospective study of 166 cases using multi-variate analysis. Stroke 1991; 22(1): 1-6.
Rojas JI, Zurru MC, Ramano M, Patrucco L, and Cristiano E. Acute ischemic stroke and transient ischemic attack in the very old-risk factor profile and stroke subtype between pa-tients older than 80 years and patients aged less than 80 years. European Journal of Neurology 2007; 14(8): 895-899.
A. Arboix, A. Vall-Llosera, L. Garcia-Eroles. J. Massons, M. Oliveres, and C. Torga. Clinical features and functional out-come of intracerebral hemorrhage in patients aged 85 and older. Journal of the American Geriatrics Society,vol 50, no 3, pp 449-454,2002.
Hu YZ, Wang JW, Luo BY. Epidemiological and clinical characteristics of 266 cases of intracerebral hemorrhage in Hangzhou, China. J. Zhenjiang Univ. Sci. B.2013; 14(6):496-504.
Namani G, Rampure DM, Murali M. Clinical profile and Mortality in patients presenting with Intra-cerebral hemor-rhage in a Tertiary Care Centre.Scholars Journal of Applied Medical Sciences (SJAMS) 2014;2(6c):3005-3010.
Ze-Li Zhang, Yu-Guang Liu, Qi-Bing Huang, Hong-Wei Wang, Yan Song, Zhen-Kuan Xu, Feng Li.Nuclear factor- kB activation in perihematomal brain tissue correlates with outcome in patients with intracerebral hemorrhage. Journal of Neuroinflammation, 2015:12:53:1-7.
Narayan SK, Sivaprasad P, Sharma S, Sahoo RK, Dutta TK. Etiology and outcome determinants of intracerebral hemor-rhage in South Indian population A hospital-based study. Ann. Indian Acad.Neurol. 2012; 15(4): 263-266.
Douglas AS, Allan TM, and Rawles JM. Composition of sea-sonality of disease. Scott. Med. J. 1991; 36: 76-82.
Feigin VL and Wiebers DO. Environmental factors and stroke: a selected review. J. Stroke Cerebrovasc. Dis. 1997; 6: 108-13.
Sloan MA, Price TR. Circardian rhythmicity of Stroke on-set.Intracerebral hemorrhage and subarachnoid hemor-rhage. Stroke1992;23:1420-26.
Mohr JP, Caplan LR et al: The Harvard cooperative stroke registry, A prospective registry. Neurology (NY) 1978; 281-754.
Bahou YG. Intracerebral hemorrhage. Neurosciences 2009; 14(2):152-157.
C.S.Kase, J.P. Mohr, and L.R.Caplan, Intracerebral hemor-rhage in stroke. Pathophysiology, Diagnosis and Manage-ment. J.P. Mohr, D.W.Choi, J.C. Grotta, B. Weir and P.A. Wolf, Eds., pp.327-376,Churchill Livingstone, Philadelph-ia,Pa,USA,2004.
L.R.Caplan,Primary Intraventricular hemorrhage in intrac-erebral hemorrhage, C.S. Kase and L.R. Caplan Eds. , pp.383-401, Butterworth-Heinemann, Newton, Mass,USA,1994.
Jeffrey L. Hackman, Melissa D. Johnson, O. John Ma. Spon-taneous subarachnoid and intracerebral haemorrhage. In: Judith E. Tintinalli, J. Stephen Stapczynski, O. John Ma, Da-vid M. Cline, Rita K. Cydulka, Garth D. Meckler, Eds. Tin-tinalli’s Emergency Medicine. 7th edition. McGraw Hill Medical Newyork; 2011:1118-1122.
Thrift AG, McNeil JJ, Forbes A, Donnan GA: Three im-portant subgroups of hypertensive persons at greater risk of intracerebral hemorrhage. Melbourne Risk factor study group. Hypertension 1998; 31:1223-1229.
Jeppesen LL, Jorgensen HS, Nakayama H. et al (1996). En-dogenous sex hormones in women with ischaemic stroke. Cerebrovasc. Dis. 1996; 6: 288-93.
US department of Health and human services.The seventh report of the joint national committee on prevention, detec-tion, evaluation, and treatment of high blood pressure, Au-gust 2004 NIH publication no 04-5230.
Willmot M,Leonardi-Bee J,Bath PM. High blood pressure in acute stroke and subsequent outcome : a systematic review Hypertension 2004; 43(1): 18-24.
Caplan L. Intracerebral haemorrhage revisited Neurology 1988; 38: 624-7.
Woo J, Lau E, Kay R. Elderly subjects aged 70 years and above have different risk factors for ischaemic and hemor-rhagic strokes compared to younger subjects. J. Am. Geriatr. Soc. 1992; 40: 124-9.
Juvela S, Hillborn M, Palomaki H. Risk factors for sponta-neous intracerebral hemorrhage.Stroke 1995; 26:1558-64.
Tetri S, Juvela S, Saloheimo P, Pyhtinen J, Hillbom M. Hy-pertension and diabetes as predictors of early death after spontaneous intracerebral hemorrhage. J. Neurosurg. 2009; 110(3): 411-17.
Fogelholm R, Murros K, Rissanen A, Avikainen S. Admis-sion blood glucose and short term survival in primary in-tracerebral haemorrhage: a population based study. J Neu-rol. Neurosurg. Psychiatry 2005; 76(3):349-353.
Broderick JP, Brott TG, Dulder JE, Tomsick T, Huster G. Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality.Stroke 1993; 24:987-993.
Brott T., Broderick J, Kothari R, et al. Early hemorrhagic growth in patients with intracerebral hemorrhage. Stroke: 1997; 28 :1-5.
Fogelholm R, Murros K, Rissanen A, et al. Long term sur-vival after primary intracerebral hemorrhage : a retrospec-tive population based study. J. Neurol. Neurosurg. Psychia-try 2005; 76: 1534-8.
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