Published: 2020-11-27

Clinicoetiological and imaging profile of intracerebral haemorrhage in a tertiary care hospital of Western Odisha

Purna Chandra Karua, Shiny Joy


Background: Intracerebral hemorrhage has an annual incidence of 10-30/100,000 population, accounting for 2 million (10-15%) of about 15 million strokes worldwide each year. The outcome of ICH depends on the clinical presentation and radiological parameters. The objective of current study was to study the etiology, clinical patterns and imaging profile in patients of intracerebral hemorrhage.

Methods: All patients admitted in department of medicine, VIMSAR, Burla, with a diagnosis of ICH during a period of November 2017 to October 2019 were evaluated for their clinical presentation, etiology and radiological parameters.

Results: A total of 105 patients with a diagnosis of ICH were included in the study. The sites of ICH were basal ganglia (49%) followed by lobar (19%), thalamus (14%), cerebellum (11%) and brain stem (8%). A pre-diagnosis of hypertension was present in 33% of the cases. Headache was the most common presenting symptom, present in 38.2% of patients followed by paralysis in 29.5%, vomiting in 27.6% and seizures in 20.9% of cases. Overall mortality rate was 39%. The mean GCS of patients who expired was 8.8 when compared to 11.28 of those patients who survived (p=0.00009). The mean hematoma size of patients who expired was 20.98 while that of those who survived was 17.41 (p=0.047). The presence of IVC was associated with mortality (p=0.006).

Conclusions: A lower GCS at presentation and a mean hematoma volume >20 ml with intraventricular extension at presentation are associated with increased mortality in ICH.


Glasgow coma scale, Mean hematoma volume, Intraventricular extension, Mortality

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Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001;344:1450-60.

Labovitz DL, Halim A, Boden-Albala B, Hauser WA, Sacco RL. The incidence of deep and lobar intracerebral hemorrhage in whites, blacks, and Hispanics. Neurology. 2005;65:518-22.

Sudlow CL, Warlow CP. Comparable studies of the incidence of stroke and its pathological types: Results from an international collaboration. International stroke incidence collaboration. Stroke. 1997;28:491-9.

Qureshi AI, Mendelow AD, Hanley DF. Intracerebral haemorrhage. Lancet. 2009;373:1632-44.

Ariesen MJ, Claus SP, Rinkel GJ, Algra A. Risk factors for intracerebral hemorrhage in the general population: A systematic review. Stroke. 2003;34: 2060-5.

Schwarz S, Häfner K, Aschoff A, Schwab S. Incidence and prognostic significance of fever following intracerebral hemorrhage. Neurology. 2000;54:354-61.

Cheung RT, Zou LY. Use of the original, modified, or new intracerebral hemorrhage score to predict mortality and morbidity after intracerebral hemorrhage. Stroke. 2003;34:1717-22.

Woo D, Sauerbeck LR, Kissela BM, Khoury JC, Szaflarski JP, Gebel J, et al. Genetic and environmental risk factors for intracerebral hemorrhage: Preliminary results of a population-based study. Stroke. 2002;33:1190-5.

Qureshi AI, Suri MF, Nasar A, Kirmani JF, Ezzeddine MA, Divani AA, et al. Changes in cost and outcome among US patients with stroke hospitalized in 1990 to 1991 and those hospitalized in 2000 to 2001. Stroke. 2007;38:2180-4.

Feigin VL, Lawes CM, Bennett DA, Anderson CS. Stroke epidemiology: A review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. Lancet Neurol. 2003;2:43-53.

Narayan SK, Sivaprasad P, Sushma S, Sahoo RK, Dutta TK. Etiology and outcome determinants of intracerebral hemorrhage in a south Indian population, A hospital-based study. Ann Indian Acad Neurol. 2012;15(4):263-6.

Omkar P. Baidya, Sunita Tiwari, Kauser Usman. Clinical profile of acute hemorrhagic stroke patients: a study in tertiary care hospital in Northern India. Int J Res Med Sci. 2014;2(4):1507-10.

Ojha P, Sardana V, Maheshwari D, Bhushan B, Kamble S. Clinical profile of patients with acute intracerebral hemorrhage and ich score as an outcome predictor on discharge, 30 Days and 60 days follow-up. J Assoc Physicians India. 2019; 67(8):14-8.

Woo D, Sauerbeck LR, Kissela BM, Khoury JC, Szaflarski JP, Gebel J, et al. Genetic and environmental risk factors for intracerebral hemorrhage: preliminary results of a population-based study. Stroke. 2002;33:1190-6.

Rymer MM. Hemorrhagic stroke: intracerebral hemorrhage. Mo Med. 2011;108(1):50-4.

Gobindram A. Stroke care: Experiences and clinical research in stroke units in Chennai. Ann Indian Acad Neurol. 2006;9:193-8.