Impact of Volume and Locations of Spontaneous Intracerebral Haemorrhage on “In – Hospital Mortality and Outcome”: A Single Centre Analysis

Document Type : Original Article

Authors

1 Department of Neurosurgery, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu-636002, India.

2 Department of Medical Gastroenterology, GEM Hospital Chennai, Tamil Nadu-636002, India.

3 Department of General Medicine, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu - 636002 India.

Abstract

Background: Spontaneous Intracerebral Hemorrhage [SICH] is the second most common cause of stroke and accounts for 7.5−30% of all strokes. In India, there still exist places where CT brain is unheard of, stroke care centers unimaginable, and supply almost always short of demand. Our analysis on potential indirect noninvasive markers and scoring systems for predicting early regarding mortality of ICH cases helps taking decision on ICH management early in clinical practice.
Aim and Objective: This study aims to determine the Influence of Spontaneous ICH volume and its anatomical location on “In-Hospital Mortality”. In addition to assess the Significance of calculating the volume of ICH at various locations and their impact on the Outcome.
Results: The NIHS Score at admission and the anatomical location on comparison was found to have infratentorial locations [32.7%] and deep location [32.3] to have severe NIHS score on admission. There was significant relation between the variation in NIHSS and anatomical location prevalence. Outcome mRS and anatomical location of SICH was found to have poor outcome scores among infratentorial location [59%]. Among the 84 cases who underwent surgical intervention 45 [53.5%] Survived while 39[46.4%] succumbed to death. The mean ICH volume among the dead was 20.25 [SD-14.53] and among survived was 18.9. [SD-12.14] with a p value of 0.38 by student T test. Among the 47 cases [55.95 % of total cases], 57.4% of the cases had poor outcome [death] and among them patients with Intra-ventricular extension of hemorrhage had very poor outcome.
Conclusion: There was significant correlation in the distribution pattern of anatomical location of SICH and immediate In hospital outcome of the patients. There was significant relation between the NIHSS, Presenting Glasgow score, clinical profile among different anatomical location. Higher ICH volume in different anatomical location was found to have higher mortality rates.

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