European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage (original) (raw)
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Cerebrovascular Diseases, 2006
Background and Purpose: Intracerebral hemorrhage (ICH) represents the severest form of stroke, yet examinations of long-term prognosis and associated health care use are rare. This study assessed survival, morbidity and cost of hospital care over 11 years following a first-ever ICH in the UK. Methods: We used a population-based retrospective inception cohort design using data from the Hospital Record Linkage System in Scotland. Long-term survival, morbidity and treatment provided in hospitals were evaluated in all patients with a first diagnosis of ICH in 1995. A cohort of ischemic stroke (IS) patients was also examined for comparison. Results: A total of 705 patients with ICH and 8,893 with IS were identified. The mean age was 65 years (SD = 17.2) for ICH and 73 years (SD = 11.8) for IS at stroke onset. The acute in-hospital mortality was 45.7 and 30.1% for ICH and IS, 51.2 and 39.9% at 1 year, while 76.0 and 80.4% were dead 11 years later. The cumulative risk of nonfatal or fatal ...
Incidence and 10-Year Survival of Intracerebral Hemorrhage in a Population-Based Registry
Stroke, 2009
Background and Purpose— The purpose of this study was to evaluate the incidence and prognosis of intracerebral hemorrhage. Methods— We analyzed data referring to our prospective population-based registry, including patients with a first-ever stroke followed up to 10 years. Results— In a 5-year period, we included 549 patients (247 men and 302 women; mean age±SD, 73.6±12.5 years) with an intracerebral hemorrhage. The crude annual incidence rate was 36.9 per 100000 (95% CI, 33.8 to 40.0), 32.9 per 100000 when standardized to the 2006 European population, and 15.9 per 100000 when standardized to the world population. The case-fatality rate was 34.6% (95% CI, 30.6 to 38.6) at 7 days; it increased to 50.3% (95% CI, 46.1 to 54.5) at 30 days and to 59.0% (95% CI, 54.9 to 63.1) at 1 year. Diabetes mellitus and posterior fossa hemorrhage were associated with an increased risk of 7- and 30-day mortality, whereas older age was associated with an increased risk of 30-day mortality only. At the ...
The Lancet Neurology, 2010
Background Since the early 1980s, imaging techniques have enabled population-based studies of intracerebral haemorrhage. We aimed to assess the incidence, case fatality, and functional outcome of intracerebral haemorrhage in relation to age, sex, ethnic origin, and time period in studies published since 1980. Methods From PubMed and Embase searches with predefi ned inclusion criteria, we identifi ed population-based studies published between January, 1980, and November, 2008. We calculated incidence and case fatality. Incidences for multiple studies were pooled in a random-eff ects binomial meta-analysis. Time trends of case fatality were assessed with weighted linear-regression analysis. Findings 36 eligible studies described 44 time periods (mid-year range 1983-2006). These studies included 8145 patients with intracerebral haemorrhage. Incidence did not decrease between 1980 and 2008. Overall incidence was 24•6 per 100 000 person-years (95% CI 19•7-30•7). Incidence was not signifi cantly lower in women than in men (overall incidence ratio 0•85, 95% CI 0•61-1•18). Using the age group 45-54 years as reference, incidence ratios increased from 0•10 (95% CI 0•06-0•14) for people aged less than 45 years to 9•6 (6•6-13•9) for people older than 85 years. Median case fatality at 1 month was 40•4% (range 13•1-61•0) and did not decrease over time, and was lower in Japan (16•7%, 95% CI 15•0-18•5) than elsewhere (42•3%, 40•9-43•6). Six studies reported functional outcome, with independency rates of between 12% and 39%. Incidence of intracerebral haemorrhage per 100 000 person-years was 24•2 (95% CI 20•9-28•0) in white people, 22•9 (14•8-35•6) in black people, 19•6 (15•7-24•5) in Hispanic people, and 51•8 (38•8-69•3) in Asian people. Interpretation Incidence of intracerebral haemorrhage increases with age and has not decreased between 1980 and 2006. Case fatality is lower in Japan than elsewhere, increases with age, and has not decreased over time. More data on functional outcome are needed. Funding Netherlands Heart Foundation. Overall, stroke case fatality has not decreased substantially over the past four decades, 1 but crude case fatality of subarachnoid haemorrhage decreased by 17% between 1972 and 2002. 7 Whether the case fatality rate of intracerebral haemorrhage has changed has not been studied in detail. Although numerous population-based studies have reported intracerebral haemorrhage epidemiology, 1 few data are available from developing countries. Data on intracerebral haemorrhage incidence, case fatality, and functional outcome in age and sex subgroups are also scarce. Although worldwide stroke epidemiology has been reviewed previously, 1 a more detailed analysis of intracerebral haemorrhage epidemiology is important for future research and management. We therefore did a meta-analysis on the incidence, case fatality, and functional outcome of intracerebral haemorrhage in relation to age, sex, ethnic origin, and time trends. Methods Search strategy and selection criteria We searched PubMed and Embase for population-based studies of intracerebral haemorrhage epidemiology from
Unmet Needs and Challenges in Clinical Research of Intracerebral Hemorrhage
Stroke, 2018
O ver 2.3 million people suffer hemorrhagic forms of stroke (intracerebral hemorrhage [ICH] and subarachnoid hemorrhage) worldwide every year; two-thirds survive with permanent disabilities. 1 Unlike its ischemic counterpart, the incidence and morbidity of hemorrhagic stroke have not declined over recent decades, and rates are substantially rising in Asia, and low-and middle-income countries. 1 There is considerable need for effective therapies to improve outcomes from hemorrhagic stroke, in particular for its most common subtype, ICH. The first HEADS (Hemorrhagic Stroke Academia Industry) roundtable was convened in Baltimore, Maryland in May 2017.
Contemporary Trends in the Nationwide Incidence of Primary Intracerebral Hemorrhage
Stroke, 2022
Background: We report contemporary trends in nationwide incidence of intracerebral hemorrhage (ICH) across demographic and regional strata over a 15-year period. Methods: Utilizing the Nationwide Inpatient Sample (2004–2018) and US Census Bureau data, we calculated ICH incidence rates for age, race/ethnicity, sex, and hospital region sub-cohorts across 5 consecutive 3-year periods (2004–2006 to 2016–2018). We fit Poisson and log binomial regression models to evaluate demographic and regional differences in ICH incidence and trends in prevalence of hypertension and past/current anticoagulant use among hospitalized ICH patients. Results: Overall, the annual incidence rate (95% CI) of ICH per 100 000 was 23.15 (23.10–23.20). The 3-year incidence of ICH (per 100 000) increased from 62.79 in 2004 to 2006 to 78.86 in 2016 to 2018 (adjusted incidence rate ratio, CI: 1.11 [1.02–1.20]), coinciding with increased 3-year prevalence of hypertension and anticoagulant use among hospitalized ICH p...
European Research Priorities for Intracerebral Haemorrhage
Cerebrovascular Diseases, 2011
mains limited. A dedicated European research programme for ICH is needed to identify ways to reduce the burden of ICH-related death and disability. The European Research Network on Intracerebral Haemorrhage EURONICH is a multidisciplinary academic research collaboration that has been established to define current research priorities and to conduct large clinical studies on all aspects of ICH.
Journal of Neurology, 2013
Data on incidence of intracerebral haemorrhage (ICH) vary widely. Population-based data on predictors of ICH survival and functional outcome are rare. The Ludwigshafen Stroke Study is a prospective, population-based stroke registry which started in January 2006. All residents of the city of Ludwigshafen, Germany, who suffer from acute stroke or transient ischaemic attack are registered. Patients with first-ever primary intracerebral haemorrhage (FE-pICH) between 2006 and 2010 were included in the present analysis. Between January 1st, 2006 and December 31st, 2010, 152 patients suffered a FE-pICH. Crude and age-adjusted incidence rates per 100,000 for FE-pICH were 18.7 (95 % CI 15.9-21.9) and 11.9 (95 % CI 10.2-14.0), respectively, and remained stable over time. Case-fatality rates for FE-pICH were 27.0, 34.9 and 44.1 % at days 28, 90 and 365, respectively. In 21 patients, an (21.3 %) early do-not resuscitate-order was documented. Excluding these patients from multivariate analyses, National Institute of Health Stroke Scale (NIHSS) (OR 1.22, 95 % CI 1.08-1.36), hypercholesterolemia (OR 0.16, 95 % CI 0.05-0.55) and modified Rankin Scale (mRS) prior to stroke (OR 1.56, 95 % CI 1.06-2.3) were independently associated with risk of 1-year mortality, whereas NIHSS (OR 1.41, 95 % CI 1.20-1.66) and leukocyte count on admission (OR 1.48, 95 % CI 1.16-1.89) were independently associated with good or moderate functional outcome (mRS B 3) after 1 year. Incidence of FE-ICH is in the lower range of those reported from other registries and remained stable over the observation period. Higher treatment rates for hypertension might partly account for this. Stroke severity as indicated by NIHSS was independently associated with mortality and functional outcome after 1 year. We found no association between aetiology and outcome in ICH patients.
Risk factors of intracerebral hemorrhage- a cross sectional study
Pakistan Journal of Neurological Sciences
BACKGROUND: Stroke is the most common cause of disability and a leading cause of mortality worldwide. Though the incidence is falling in West but probably rising in Asia. The burden of stroke risk factors in Pakistan is enormous. Data on stroke incidence and prevalence from Pakistan is scarce; however, there are several reported case series in literature highlighting significant differences in terms of stroke epidemiology, risk factors and stroke subtypes/patterns. METHODS: This descriptive cross sectional study was conducted from August 2019 to February 2020, on 109 patients from medical units of DHQ Teaching Hospital Abbottabad. Diagnosis of cerebrovascular accidents was made on focal neurological deficit lasting more than 24 hours. CT scan brain was done in all patients to detect intra cerebral bleed. Detailed history and medical records were carefully scrutinized in the patients of intracerebral bleed to detect factors leading to it like uncontrolled hypertension. Fasting blood ...