Risk factors for spontaneous cerebral hematomas. Case-control study.

Abstract

SUMMARY In a case-control study of 73 cases of cerebral hematoma diagnosed by CT scan, significant risk factors were history of hypertension, chronic alcoholism, evidence of hepatic disease, EKG abnormalities and high hematocrit values. Initial blood pressure was significantly higher in cases, but blood pressure on the third day after admission was not different from controls. Hypertension and alcoholism did not show a clear correlation, but data from other studies explain the role of alcoholism in vascular disease through a relation with high blood pressure. Risk factors were similar in lobar and basal ganglia hematomas.Stroke Vol 17, No 6, 1986 SPONTANEOUS INTRACEREBRAL HEMATOMAS (CH) constitute about a 10% of stroke cases. Since CH treatment is poor, prevention is at least as important as for cerebral infarction. Risk factors for CH occurrence have been scarcely studied. '^ Furthermore, these studies were carried out before CT scan was available. It has been shown that many cases of CH can be misdiagnosed as cerebral infarction if CT scan is not used for diagnosis.5 These facts prompted us to study risk factors in a case-control study of our population of CT scan diagnosed cerebral hematomas. Patients and MethodsThis is a retrospective case-control study carried out on 73 CH patients consecutively admitted to the Department of Neurology. Inclusion criteria were: evidence of spontaneous CH on CT scan (isolated subarachnoid or intraventricular hemorrhage and traumatic CH were excluded); admission within the week following the development of stroke; absence of cerebral tumor, aneurysm or angioma (on CT scan or angiography). The control group was formed by 73 patients, paired in age and sex with cases, selected from neurological patients devoid of cerebrovascular or toxic-nutritional disease (excluding also dementia, loss of consciousness, epilepsy, parkinsonism and cerebellar syndrome patients). Data analyzed were the following: history of hypertension (with or without treatment), history of alcohol consumption (more than 80 grams per day at least in the previous year), history of liver disease or current evidence (clinical or pathological) of hepatopathy and evidence of coagulation disorder or previous anticoagulant treatment. Blood pressure (BP) levels were measured on admission and after 3 days. Blood glucose, cholesterol, triglyceride and hematocrit were measured within the first three days after admission. Electrocardiogram (EKG), performed in the week following admission, was considered to be abnormal when showing evidence of myocardial infarction, atrial fibrillation or flutter and ventricular hypertrophy. Statistical significance in differences between groups was studied by means of rela- ResultsIn each of the groups (cases and controls) there were 52 males and 21 females, and the mean age was 58 years (range: 23 to 82). Results from qualitative data are set out in table 1. The most relevant factors were history of hypertension and alcoholism. Also significant were the presence of hepatic disease and...

High ethanol consumption as risk factor for intracerebral hemorrhage in young and middle-aged people.

“…On the other hand, the higher frequency in alcoholic patients of lobar hematomas rather than basal ganglia hematomas (which our hypertensive cases exhibited) suggests that the pathogenetic mechanisms of hematomas in these locations differ. The fact that Calandre et al 9 found no differences in the risk factors for lobar and basal ganglia hematomas could be attributed to the effect of other confounding factors, mainly age, since elderly people were included in that series.…”

“…Thus, Donahue et al 8 reported a high prevalence of moderate and heavy drinkers among patients with hemorrhagic strokes, especially strokes of subarachnoid origin. Calandre et al 9 found that chronic alcoholism was the strongest risk factor for intracerebral hemorrhage in a retrospective case-control study in Spain. Finally, in their prospective series Niizuma et al 15 explored the influence of liver dysfunction in the pathogenesis of intracerebral hemorrhage and found an ethanol intake of >50 g/day in 37% of their patients.…”

“…7 " 9 We conducted a case-control study to assess the role of high ethanol intake and its relation to other risk factors in the development of intracerebral hemorrhage in young and middle-aged people.…”

Hemorragia intraparenquimatosa encefálica espontânea: achados à tomografia computadorizada

“…Tais resultados são semelhantes quando comparados a outros trabalhos 2,8,9,[21][22][23][24][25][26] .…”

Editorial Comment—Minor Risk Factors for Intracerebral Hemorrhage: The Jury Is Still Out

“…The overall OR crude was 1.01 (95% CI, 0.71 to 1.44). 15,17,18,20,25-29 The investigators of 3 cohort studies reported on ever smoking for an overall RR adjusted of 1.07 (95% CI, 0.88 to 1.31). 4,9,31 Combining the case-control and cohort studies resulted in an overall RR of 1.06 (95% CI, 0.89 to 1.26).…”