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Influence of Intracerebral Hemorrhage Location on Incidence, Characteristics, and Outcome Population-Based Study

Lookup NU author(s): Professor Phil White

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Abstract

Background and Purpose-The characteristics of intracerebral hemorrhage (ICH) may vary by ICH location because of differences in the distribution of underlying cerebral small vessel diseases. Therefore, we investigated the incidence, characteristics, and outcome of lobar and nonlobar ICH.Methods-In a population-based, prospective inception cohort study of ICH, we used multiple overlapping sources of case ascertainment and follow-up to identify and validate ICH diagnoses in 2010 to 2011 in an adult population of 695 335.Results-There were 128 participants with first-ever primary ICH. The overall incidence of lobar ICH was similar to nonlobar ICH (9.8 [95% confidence interval, 7.7-12.4] versus 8.6 [95% confidence interval, 6.7-11.1] per 100 000 adults/y). At baseline, adults with lobar ICH were more likely to have preceding dementia (21% versus 5%; P=0.01), lower Glasgow Coma Scale scores (median, 13 versus 14; P=0.03), larger ICHs (median, 38 versus 11 mL; P<0.001), subarachnoid extension (57% versus 5%; P<0.001), and subdural extension (15% versus 3%; P=0.02) than those with nonlobar ICH. One-year case fatality was lower after lobar ICH than after nonlobar ICH (adjusted odds ratio for death at 1 year: lobar versus nonlobar ICH 0.21; 95% confidence interval, 0.07-0.63; P=0.006, after adjustment for known predictors of outcome). There were 4 recurrent ICHs, which occurred exclusively in survivors of lobar ICH (annual risk of recurrent ICH after lobar ICH, 11.8%; 95% confidence interval, 4.6%-28.5% versus 0% after nonlobar ICH; log-rank P=0.04).Conclusions-The baseline characteristics and outcome of lobar ICH differ from other locations.

Publication metadata

Author(s): Samarasekera N, Fonville A, Lerpiniere C, Farrall AJ, Wardlaw JM, White PM, Smith C, Salman RA, Lothian Audit Treatment Cerebral

Publication type: Article

Publication status: Published

Journal: Stroke

Year: 2015

Volume: 46

Issue: 2

Pages: 361-368

Print publication date: 01/02/2015

Online publication date: 13/01/2015

Acceptance date: 10/12/2014

Date deposited: 18/09/2015

ISSN (print): 0039-2499

ISSN (electronic): 1524-4628

Publisher: Lippincott Williams & Wilkins

URL: http://dx.doi.org/10.1161/STROKEAHA.114.007953

DOI: 10.1161/STROKEAHA.114.007953

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