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Non-Traumatic Intracerebral Hematoma in the Young: Findings from a Tertiary Hospital in the Philippines

There is geographic variability in the clinical profile and outcomes of non-traumatic intracerebral hematoma (ICH) in the young, and data for the Philippines is lacking. We aimed to describe this in a cohort from the Philippines, and identify predictors of mortality. We performed a retrospective stu...

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Published in:Journal of stroke and cerebrovascular diseases 2020-11, Vol.29 (11), p.105242-105242, Article 105242
Main Authors: Enriquez, Clare Angeli G., Omar, Abdelsimar T., Medrano, Jose Miguel M., Diestro, Jose Danilo B., Ochoco, Gerard Eastdon Truadio D., Spears, Julian, Khu, Kathleen Joy O., Pineda-Franks, Maria Carissa
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Language:English
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Summary:There is geographic variability in the clinical profile and outcomes of non-traumatic intracerebral hematoma (ICH) in the young, and data for the Philippines is lacking. We aimed to describe this in a cohort from the Philippines, and identify predictors of mortality. We performed a retrospective study of all patients aged 19–49 years with radiographic evidence of non-traumatic ICH admitted in our institution over five years. Data on demographics, risk factors, imaging, etiologies, surgical management, in-hospital mortality, and discharge functional outcomes were collected. Multivariate logistic regression analysis was done to determine factors predictive of mortality. A total of 185 patients were included, which had a mean age of 40.98 years and a male predilection (71.9%). The most common hematoma location was subcortical, but it was lobar for the subgroup of patients aged 19-29 years. Overall, the most common etiology was hypertension (73.0%), especially in patients aged 40-49. Conversely, the incidence of vascular lesions and thrombocytopenia was higher in patients aged 19-29. Surgery was done in 7.0% of patients. The rates of mortality and favorable functional outcome at discharge were 8.7% and 35.1%, respectively. Younger age (p = 0.004), higher NIHSS score on admission (p=0.01), higher capillary blood glucose on admission (p=0.02), and intraventricular extension of hematoma (p = 0.01) predicted mortality. In the Philippines, the most common etiology of ICH in young patients was hypertension, while aneurysms and AVM's were the most common etiology in the subgroup aged 19 – 29 years. Independent predictors of mortality were identified.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2020.105242