Long-term prognosis of hypertensive intracerebral hemorrhage.

Douglas, Margaret A.; Haerer, Armin F.

doi:10.1161/01.str.13.4.488

Cited by 121 publications

(60 citation statements)

References 10 publications

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“…In addition, relatively short follow-up and a small patient population make difficult any determination as to whether the lack of observed recurrence reflected a real difference between hypertension-related ICH and the play of chance. 11 An additional study did not report the relationship between hypertension and lobar or nonlobar hemorrhage, neither at index event nor with recurrence. However, these authors also conclude that lobar ICH is more likely to recur.…”

Section: Resultsmentioning

confidence: 98%

“…2 Lobar location of the index ICH appeared to confer a higher risk of recurrent ICH compared with deep, hemispheric ICH (table 3; rate ratio 2.2; p ϭ 0.002) based on data from four studies. 6,8,9,11 The aggregate rate of recurrent ICH in the 192 patients with initial lobar ICH was 4.4% per patient-year (95% CI, 3.1% to 6.3%) versus 2.1% per patient-year (95% CI, 1.6% to 2.7%) among the 823 patients whose index event was a deep, hemispheric ICH. When data from an additional trial that was restricted to survivors of primary lobar ICH were added to the analysis, the rate of ICH recurrence in patients surviving primary lobar ICH was 5.4% per patient-year (95% CI, 4.1% to 7.1%).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Primary cerebral amyloidoma

Blättler¹,

Siegel²,

Jochum³

et al. 2001

Neurology

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Article abstract-Objective: To characterize the rates of recurrent intracranial hemorrhage (ICH), ischemic stroke, and death in survivors of primary ICH. Methods: Systematic review of studies reporting recurrent stroke in survivors of primary ICH, identified at index ICH and followed forward. Studies were identified by computerized search of the literature and review of reference lists. Results: Ten studies published between 1982 and 2000 reporting 1,880 survivors of ICH, followed for a total of 6,326 patient-years (mean follow-up, 3.4 patient-years), were included. The aggregate rate of all stroke from five studies was 4.3% per patient-year (95% CI, 3.5% to 5.4%). The rate in the three population-based studies was higher than in the two hospital-based studies, 6.2% versus 4.0% per patient-year (p ϭ 0.04). About three fourths of recurrent strokes were ICH. Considering all 10 studies, a total of 147 patients had a recurrent ICH, an aggregate rate of 2.3% per patient-year (95% CI, 1.9% to 2.7%). Based on data from four studies, patients with a primary lobar ICH had a higher rate of recurrent ICH than those with a deep, hemispheric ICH (4.4% versus 2.1% per patientyear; p ϭ 0.002). The aggregate rates of subsequent ischemic stroke and mortality were 1.1% per patient-year (95% CI, 0.8% to 1.7%) and 8.8% per patient-year (95% CI, 5.2% to 11.0%). Conclusions: Recurrent stroke among survivors of primary ICH occurs at a rate of about 4% per patient-year, and most are recurrent ICH. Survivors of ICH have a higher risk of recurrent ICH than of ischemic stroke, and this has implications for the use of antithrombotic agents in these patients. NEUROLOGY 2001;56:773-777 Intracranial hemorrhage (ICH) accounts for 10% to 15% of all strokes and carries substantial associated mortality and often permanent disability for those affected.1 For the estimated 50,000 Americans who survive ICH each year, the risk of recurrent stroke and death are unclear. We undertook a systematic review of this issue, seeking to characterize the occurrence of recurrent ICH, ischemic stroke and death among survivors of primary ICH, as well as to identify predictors of recurrent stroke. We hypothesized a priori that recurrence of ICH would be infrequent and that subsequent stroke more often would be ischemic than hemorrhagic. Methods. Types of studies.Studies of patients identified at the time of a primary ICH, followed longitudinally, and evaluated for recurrent stroke were considered for inclusion. Minimum average follow-up required for a study to be included was 3 months.Types of participants. We included studies of patients of any age or gender surviving a primary ICH for at least 30 days. When possible, the studies confirmed ICH by CT or MRI and excluded those due to vascular malformation, coagulopathy, trauma, or neoplasm.Types of interventions. There were no restrictions as to the type of intervention.Types of outcome measures. The primary outcomes evaluated were recurrent intracranial hemorrhage (any hemorrhage confirmed by CT, MRI, or autopsy...

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Primary cerebral amyloidoma

Blättler¹,

Siegel²,

Jochum³

et al. 2001

Neurology

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“…Several prognostic factors have been identified in previous studies of ICH, including the level of consciousness at presentation, 42 hematoma size, 43 and intraventricular extension. 44 In the present series, the prognosis was poor in a univariate analysis that included hypertension as cause of ICH and ventricular extension, which was associated with the ICH located in the basal ganglia.…”

Section: Discussionmentioning

confidence: 99%

Intracerebral Hemorrhage in Young People

Ruiz-Sandoval

Cantú

Barinagarrementería

1999

Stroke

206

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Background and Purpose-The frequency of intracerebral hemorrhages (ICHs) in people aged Յ40 years has been poorly studied. We investigated the incidence, causes, locations, and prognosis of ICH in young patients. Methods-We evaluated all consecutive patients with neuroimaging evidence or pathological confirmation of symptomatic ICH. We excluded patients with primary subarachnoid or traumatic hemorrhage, past evidence of vascular malformation, or brain tumor. We analyzed the risk factors, number, locations, and causes of ICH, and final outcome measured by the modified Glasgow Outcome Scale. Results-We retrospectively evaluated 200 patients (mean age, 27 years; range, 15 to 40 years). The most frequent risk factors were tobacco use (20%), hypocholesterolemia (35%), hypertension, (13%), and alcohol use (10%). The locations of ICH were lobar (55%), basal ganglia/internal capsule (22%), and others (24%). The most common causes of ICH were vascular malformations (49%), including cavernous angioma, and hypertension (11%). Cryptogenic ICH was considered in 15%. Other causes included cerebral venous thrombosis (5%) and sympathomimetic drug use (4%). The majority of patients with ICH that resulted from hypertension were aged Ͼ31 years (odds ratio, 3.48), and those with ICH that resulted from arteriovenous malformations were aged Ͻ20 years (odds ratio, 2.80). The final outcome was considered favorable in 60%. Conclusions-ICHs

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“…'6'7 For the assessment of outcome after one year, the Rankin scale was contracted into two categories: functionally independent (corresponding to grades zero, one or two) and functionally dependent (corresponding to grades three, four or five). The severity of the hemiparesis was estimated according to the Medical Research Council scale, in the most severely affected muscle groups and dichotomised in severe (0-2) versus moderate to no hemiparesis or normal power (3)(4)(5). Blood glucose levels could be obtained in all but 19 patients.…”

Section: Methodsmentioning

confidence: 99%

Prognostic factors in patients with intracerebral haematoma.

Franke

Swieten

Algra

et al. 1992

Journal of Neurology, Neurosurgery & Psychiatry

189

105

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In a prospective study, the prognostic value of clinical characteristics in 157 consecutive patients with spontaneous supratentorial intracerebral haemorrhage were examined by means of multivariate analysis.Two days after the event 37 (24%) patients had died. Factors independently contributing to the prediction of two day mortality were pineal gland displacement on CT of 3 mm or more (p < 0-001), blood glucose level on admission of 8-0 mmolIl or more (p = 0-01), eye and motor score on the Glasgow Coma Scale of eight out of 10 or less (p = 0.022) and haematoma volume of 40 cm3 or more (p = 0.037).Between the third day and one year after the event another 46 of the 120 two day survivors had died; the independent prognostic indicators for death during that period were: age 70 years or more (p < 0-001) and severe handicap (Rankin grade five) on the third day (p < 0-001). Functional independence (Rankin grade two or less) at one year was most common not only with the converse features of age less than 70 years (p < 0-01) and Rankin grade four or less on the third day (p = 0.002), but also with an eye and motor score on the Glasgow Coma Scale of nine or 10 on the third day (p < 0.001).The 120 patients with intracerebral haemorrhage who were still alive two days after the event were matched with 120 patients with cerebral infarction, according to age, level of consciousness on the third day after stroke (Glasgow Coma Scale) and handicap (Rankin grade). Survival and handicap after one year did not differ between these two groups. The conclusion drawn is that it is not the cause (intracerebral haemorrhage or cerebral infarction) but the extent of the brain lesion that determines the outcome in patients who survive the first two days. (7 Neurol Neurosurg Psychiatry 1992;55:653-657)

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Long-term prognosis of hypertensive intracerebral hemorrhage.

Cited by 121 publications

References 10 publications

Primary cerebral amyloidoma

Primary cerebral amyloidoma

Intracerebral Hemorrhage in Young People

Prognostic factors in patients with intracerebral haematoma.

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