J Cerebrovasc Endovasc Neurosurg.  2013 Sep;15(3):214-220. 10.7461/jcen.2013.15.3.214.

The Outcomes of Spontaneous Intracerebral Hemorrhage in Young Adults - A Clinical Study

• Go GO
• Park H
• Lee CH
• Hwang SH
• Han JW
• Park IS

• KMID: 1491441
• DOI: http://doi.org/10.7461/jcen.2013.15.3.214

Abstract

OBJECTIVE
Spontaneous intracerebral hemorrhage (ICH) in young adults is rare. The purpose of this study was to investigate causes, sites and other factors affecting the prognosis of ICH in young adults aged < or = 40 years.
METHODS
We reviewed 39 consecutive patients diagnosed with spontaneous ICH between January 2001 and June 2012. Patients with primary subarachnoid hemorrhage, previously diagnosed brain tumor bleeding, or vascular malformation were excluded. We analyzed the differences in prognostic factors such as hemorrhage location and vascular structural etiology. The outcome was measured using the Glasgow outcome scale (GOS), and a good outcome was defined as a score of 4 or more.
RESULTS
We retrospectively evaluated 39 patients (mean age, 33 years; SD = 6.4, range 17 to 40 years). The most common structural etiology was arteriovenous malformation. A statistically significantly higher proportion of patients with good outcomes had a lower initial systolic blood pressure (SBP < or = 160 mmHg, p = 0.036), a higher initial Glasgow coma scale (GCS) (9 or more, p = 0.034), lower cholesterol levels (< 200 mg/dl, p = 0.036), and smoking history (at discharge, p = 0.008; 6 months after discharge, p = 0.019).
CONCLUSION
In this study, cryptogenic ICH was the leading cause of spontaneous ICH. A GCS score of 9 or more on admission, a lower serum cholesterol level (< 200 mg/dl), and a lower SBP (< 160 mmHg) predicted a good outcome.

Keyword

Intracerebral hemorrhage; Outcomes; Prognostic factors; Spontaneous; Young adult

MeSH Terms

Aged
Arteriovenous Malformations
Blood Pressure
Brain Neoplasms
Cerebral Hemorrhage
Cholesterol
Glasgow Coma Scale
Glasgow Outcome Scale
Hemorrhage
Humans
Prognosis
Retrospective Studies
Smoke
Smoking
Subarachnoid Hemorrhage
Vascular Malformations
Young Adult
Cholesterol
Smoke

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