Intracerebral hemorrhage

Objectives: To study intracerebral hemorrhage (ICH)at Jordan University Hospital (JUH) with the aim of assessing prevalence, age/gender distribution, causes,clinical manifestations, and location of ICH on CTbrain, treatment modalities and outcome, and to compare these findings with those from MiddleEastern and Western literature.Methods: Among 1498 patients with stroke seen overa 6-year-period, from January 2002 to December2007 at JUH, Amman, Jordan, 100 patients withspontaneous ICH were studied retrospectively.Results: The prevalence of ICH was 6.7%. The meanage was 61 years, with 71 males, and 29 females.The most common cause was hypertension, alone or combined with the use of aspirin and/or warfarin.The most common clinical manifestations were hemiparesis/plegia, impaired level of consciousness(mean Glasgow coma scale [GCS] score = 7.3) and headache/vomiting. The most common locationon CT brain was in the basal ganglia (61 patients).Seventy-nine patients received medical treatment and 21 had surgery. Forty-two patients died after a meanof 7 days (ranging from one day to 6 weeks). The factors related to mortality were old age 68 years,GCS 8, intraventricular extension of ICH on CTbrain and the presence of other comorbidities. Among58 survivors, 50 were left with neurological deficit,predominantly hemiparesis/plegia in 46 patients.Twelve patients were left with chronic epilepsy.Conclusion: This study shows a lower prevalence of ICH compared to developed countries, a similarage and gender distribution, and hypertension as the major risk factor, which should be the focus of public health in Jordan and the Arab World.