Intracerebral hemorrhage outcome: A comprehensive update

• Published in: Journal of the neurological sciences Vol. 398; pp. 54 - 66
• Main Authors: Pinho, João, Costa, Ana Sofia, Araújo, José Manuel, Amorim, José Manuel, Ferreira, Carla
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.03.2019
• Subjects: Cerebral Hemorrhage - complications; Cerebral Hemorrhage - mortality; Cerebral Hemorrhage - psychology; Cognitive Dysfunction - etiology; Cognitive Dysfunction - mortality; Cognitive Dysfunction - psychology; Functional outcome; Humans; Intracerebral hemorrhage; Mental Disorders - etiology; Mental Disorders - mortality; Mental Disorders - psychology; Mortality; Mortality - trends; Patient Reported Outcome Measures; Prognosis; Quality of Life - psychology; Prognosis; Mortality; Intracerebral hemorrhage; Functional outcome
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2019.01.013

Non-traumatic intracerebral hemorrhage (ICH) is associated with a significant global burden of disease, and despite being proportionally less frequent than ischemic stroke, in 2010 it was associated with greater worldwide disability-adjusted life years lost. The focus of outcome assessment after ICH has been mortality in most studies, because of the high early case fatality which reaches 40% in some population-based studies. The most robust and consistent predictors of early mortality include age, severity of neurological impairment, hemorrhage volume and antithrombotic therapy at the time of the event. Long-term outcome assessment is multifaceted and includes not only mortality and functional outcome, but also patient self-assessment of the health-related quality of life, occurrence of cognitive impairment, psychiatric disorders, epileptic seizures, recurrent ICH and subsequent thromboembolic events. Several scores which predict mortality and functional outcome after ICH have been validated and are useful in the daily clinical practice, however they must be used in combination with the clinical judgment for individualized patients. Management of patients with ICH both in the acute and chronic phases, requires health care professionals to have a comprehensive and updated perspective on outcome, which informs decisions that are needed to be taken together with the patient and next of kin. •Outcome after ICH should be assessed taking into consideration multiple domains.•ICH carries a high short- and long-term mortality risk.•Patient reported outcomes should be increasingly reported in ICH patients.•Scores to predict survival, functional outcome and hematoma growth are available.