J Stroke.  2017 Jan;19(1):3-10. 10.5853/jos.2016.00864.

Epidemiology, Risk Factors, and Clinical Features of Intracerebral Hemorrhage: An Update

Affiliations
  • 1Department of Neurology, Seoul National University Hospital, Seoul, Korea. bwyoon@snu.ac.kr

Abstract

Intracerebral hemorrhage (ICH) is the second most common subtype of stroke and a critical disease usually leading to severe disability or death. ICH is more common in Asians, advanced age, male sex, and low- and middle-income countries. The case fatality rate of ICH is high (40% at 1 month and 54% at 1 year), and only 12% to 39% of survivors can achieve long-term functional independence. Risk factors of ICH are hypertension, current smoking, excessive alcohol consumption, hypocholesterolemia, and drugs. Old age, male sex, Asian ethnicity, chronic kidney disease, cerebral amyloid angiopathy (CAA), and cerebral microbleeds (CMBs) increase the risk of ICH. Clinical presentation varies according to the size and location of hematoma, and intraventricular extension of hemorrhage. Patients with CAA-related ICH frequently have concomitant cognitive impairment. Anticoagulation related ICH is increasing recently as the elderly population who have atrial fibrillation is increasing. As non-vitamin K antagonist oral anticoagulants (NOACs) are currently replacing warfarin, management of NOAC-associated ICH has become an emerging issue.

Keyword

Cerebral hemorrhage; Epidemiology; Incidence; Risk factors; Neurologic manifestations

MeSH Terms

Aged
Alcohol Drinking
Anticoagulants
Asian Continental Ancestry Group
Atrial Fibrillation
Cerebral Amyloid Angiopathy
Cerebral Hemorrhage*
Cognition Disorders
Epidemiology*
Hematoma
Hemorrhage
Humans
Hypertension
Incidence
Male
Mortality
Neurologic Manifestations
Renal Insufficiency, Chronic
Risk Factors*
Smoke
Smoking
Stroke
Survivors
Warfarin
Anticoagulants
Smoke
Warfarin
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