Does the Volume and Localization of Intracerebral Hematoma Affect Short-Term Prognosis of Patients with Intracerebral Hemorrhage?

The aim of this study was to determine whether volume and localization of intracerebral hematoma affects the six-month prognosis of patients with intracerebral hemorrhage (ICH). Patients and Methods. The study included 75 patients with ICH of both sex and all age groups. ICH, based on CT scan findings, was divided in the following groups: lobar, subcortical, infratentorial, intraventricular haemorrhage and multiple hematomas. Volume of intracerebral hematoma was calculated according to formula . Intracerebral hematomas, according to the volume, are divided in three groups (0–29？mL, 30–60？mL, and >60？mL). Results. The highest mortality rate was recorded in the group with multiple hematomas (41%), while the lowest in infratentorial (12.8%). The best six-month survival was in patients with a volume up to 29 mL, 30 of them (64%) survived. The highest mortality rate was recorded in patients with the hematoma volume >60？mL (85%). Kaplan-Meier’s analysis showed that there was statistical significance between the size of the hematoma and the six-month survival ( ). More than half of patients (61.1%) who survived 6 months after ICH were functionally independent (Rankin scale ≤2). Conclusion The volume of hematoma significantly affects six-month prognosis in patients with intracerebral hemorrhage, while localization does not. 1. Introduction Intracerebral hemorrhage (ICH) is defined as bleeding into the parenchyma of the brain which may further extend into ventricles. ICH occurs in 15 to 20% of all strokes. Compared to ischemic stroke, it more often results in death and increased disability [1]. The most important risk factor is hypertension, which increases the risk of ICH by approximately 4 times. Improved hypertension control reduces the incidence of intracerebral haemorrhage [2]. The other causes of ICH are arteriovenous malformation, brain tumor, amyloid angiopathy, and blood or bleeding disorders. A three-month mortality of ICH is 34%, while only 31% of patients are functionally independent 3 months after ICH. ICH can be localized in the different parts of the brain (cerebral lobes, basal ganglia, thalamus, brainstem, and cerebellum), and large hematoma is accompanied with spreading of blood into ventricles [1]. The aim of this study was to determine whether the volume and localization of intracerebral hematoma affects the six-month prognosis of patients with ICH. 2. Patients and Methods The study included 75 patients with ICH of both sexes and all age groups, hospitalized at the Department of Neurology, Tuzla, Bosnia and Herzegovina, in the period from