Intracerebral Hemorrhage in a Young Urban Population: Etiologies and Outcomes in Patients 50 and Younger

• Published in: Journal of stroke and cerebrovascular diseases 2019-10, Vol.28 (10), p.104295-104295, Article 104295
• Main Authors: Gedansky, Aron, Jarvis, Paul, Yu, Daohai, Lu, Xiaoning, Heiman-Patterson, Terry, Linares, Guillermo
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Cerebral Hemorrhage - diagnostic imaging; Cerebral Hemorrhage - epidemiology; Cerebral Hemorrhage - mortality; Cerebral Hemorrhage - therapy; Female; Hemorrhage; Humans; Hypertension - diagnosis; Hypertension - epidemiology; intracerebral hemorrhage; Male; Middle Aged; Philadelphia - epidemiology; populations at risk for stroke; Prevalence; Prognosis; Retrospective Studies; Risk Factors; Severity of Illness Index; stroke; stroke in young populations; Urban Health; Young Adult
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2019.07.011

Goal: There is limited research on intracerebral hemorrhage in young urban populations. There is reduced access to healthcare and a high prevalence of multiple comorbidities in this vulnerable population. We studied the etiologies and outcomes of spontaneous intracerebral hemorrhage in an urban North Philadelphia cohort aged 50 years old and younger. Materials and methods: A retrospective chart review of subjects 50 years old and younger who presented with spontaneous intracerebral hemorrhage at Temple University Hospital was conducted. A novel scoring system was used to classify the cause of each intracerebral hemorrhage. This system was used to assign a degree of likelihood that hypertension, amyloid angiopathy, tumor, oral anticoagulants, vascular malformations, infrequent causes, or cryptogenic etiologies were present. Aneurysmal subarachnoid hemorrhage was excluded. The prevalence of each risk factor and outcomes were analyzed. Findings: Of the 110 patients in the study, the most common etiology was hypertension (82.7%). There was no statistically significant difference in mortality between patients with multiple possible etiologies for their hemorrhage. Vascular malformations and cavernomas were rare (5.5%). Conclusions: Hypertension was the most common cause of intracerebral hemorrhage in a young urban population. The presence of multiple possible etiologies does not correlate with a worse prognosis of mortality. There is a need for further research into hemorrhagic stroke in young populations.