Intracerebral hemorrhage

ABSTRACT

To study intracerebral hemorrhage [ICH] at Jordan University Hospital [JUH] with the aim of assessing prevalence, age/gender distribution, causes, clinical manifestations, and location of ICH on CT brain, treatment modalities and outcome, and to compare these findings with those from Middle Eastern and Western literature. Among 1498 patients with stroke seen over a 6-year-period, from January 2002 to December 2007 at JUH, Amman, Jordan, 100 patients with spontaneous ICH were studied retrospectively. The prevalence of ICH was 6.7%. The mean age was 61 years, with 71 males, and 29 females. The most common cause was hypertension, alone or combined with the use of aspirin and/or warfarin. The most common clinical manifestations were hemiparesis/plegia, impaired level of consciousness [mean Glasgow coma scale [GCS] score = 7.3] and headache/vomiting. The most common location on CT brain was in the basal ganglia [61 patients]. Seventy-nine patients received medical treatment and 21 had surgery. Forty-two patients died after a mean of 7 days [ranging from one day to 6 weeks]. The factors related to mortality were old age >68 years, GCS <8, intraventricular extension of ICH on CT brain and the presence of other comorbidities. Among 58 survivors, 50 were left with neurological deficit, predominantly hemiparesis/plegia in 46 patients. Twelve patients were left with chronic epilepsy. This study shows a lower prevalence of ICH compared to developed countries, a similar age and gender distribution, and hypertension as the major risk factor, which should be the focus of public health in Jordan and the Arab World