Background and Purpose--Hematoma expansion has been identified as a crucial predictor for the progress and outcome of intracranial hemorrhage(ICH). MicroRNAs (miRNAs) are associated with hematoma expansion and play important roles in regulating the mechanism of ICH. Here, we identified a miRNA, hsa-miR-1278, as a predictor of hematoma expansion and earlier estimation of ICH prognosis.<break> <break>MethodsThe participants who had been diagnosed with ICH by brain imaging were divided into hematoma enlargement(HE) group and non-HE group. A total of 10 samples from 2 groups were extracted and subjected to high-throughput sequencing. The differentially expressed microRNAs (DEMs) were identified by bioinformatics and quantitated by reverse transcription-polymerase quantitive chain reaction(RT-qPCR). To further validate the DEMs, We searched the Targescan database to find the target gene of the DEM and cultured the QSG7701 cells line and performed western blotting to validated the target miRNA. The Continuous variables were expressed as mean SD and analyzed by unpaired Student's t-test; categorical variables were analyzed by chi-square test, and P values < 0.05 were considered statistically significant.<break> <break>Results----We performed miRNA sequencing of HE and non-HE in 10 patients with cerebral hemorrhage. We found 18 differentially expressed miRNAs in HE group. We then performed RT-qPCR verification and identified that hsa-miR-1278 was significantly increased in the HE group (P <0.05). By searching Targescan database and genes related to ICH, we selected IL22 and PF4 as the target genes of has-miR-1278. RT-qPCR showed that PF4 were decrease in HE, which was consistent with the increased of hsa-miR-1278.<break> <break>Conclusions: The expression of hsa-miR-1278 was still significantly up-regulated in the hematoma expansion group, and therefore made the hsa-miR-1278 as a novel predictor of ICH prognosis.