Predictors of early neurological deterioration in patients with spontaneous intracerebral hemorrhage

Abdelwahab, Ahmed Hussen; Kamel, Amr; Mohamed, Wafaa Samir; Mahdy, Mohammed Elsayed

doi:10.21608/zumj.2020.25648.1769

Predictors of early neurological deterioration in patients with spontaneous intracerebral hemorrhage

Document Type : Original Article

Authors

¹ Neurology Department, Faculty of Medicine, Zagazig University, El-Sharkia, Egypt.

² Neurology Department, Faculty of medicine, Zagazig University, Egypt.

³ Neurology department faculty of medicine zagazig university

⁴ Neurology department,Faculty of Medicine ,Zagazig University ,Zagazig , Egypt

10.21608/zumj.2020.25648.1769

Abstract

Abstract:

Background: Intracerebral hemorrhage (ICH) is the second most common cause of stroke, following ischemic stroke and has been described to be associated with high morbidity and mortality.

Aim: We investigated the association between the clinical, laboratory and radiographic factors on one hand and early neurological deterioration (END) after first ever intracerebral hemorrhage (ICH) on the other hand.

Patients and methods: We identified forty consecutive patients with ICH who were admitted to the stroke or intensive care units of the Neurology Department Zagazig University Hospitals within the first 24 hours of onset. Mean age was 58.125±11.37 years ranging from 30 to 83 years with median of age 60 years. Males were 31 (77.5%) and 9 (22.5%) were females. Glasgow Coma Scale (GCS) score, National Institute of Health Stroke Scale (NIHSS) score, laboratory investigations, and radiological investigations to assess the site and size of the intracerebral hematoma were recorded on admission. The study endpoint was the occurrence of END within 7 days after ICH.

Results: We found that males were 31 (77.5%) and 9 (22.5%) were females. six of our patients (15%) presented END. Lower GCS score, higher NIHSS score, lobar hematoma, and larger hematoma volume were independent predictors for END after ICH.

Conclusion: There are different early predictors of spontaneous intracerebral hemorrhage (sICH) outcome which can be classified into clinical predictors, laboratory predictors and radiological predictors which can help in the risk categorization of patients.

Keywords: intracerebral hemorrhage, predictors, early neurological deterioration, outcome.

Keywords