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Is nontraumatic intracerebral hemorrhage different between young and elderly patients?

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Abstract

Only a few studies have reported nontraumatic intracerebral hemorrhage in young patients notwithstanding its fatal and devastating characteristics. This study investigated the clinical characteristics and outcome of nontraumatic intracerebral hemorrhage in young patients in comparison to those of the elderly. A retrospective review of consecutive patients admitted at the department of neurosurgery of two tertiary care medical centers presenting with first-ever nontraumatic intracerebral hemorrhage was performed. We identified and compared the demographics, etiologies, risk factors, and laboratory, radiological, and clinical findings between elderly and young patients. Additionally, logistic regression analyses of independent prognostic factors associated with 1-month mortality and favorable functional outcome were performed. Altogether, 247 patients including 69 young patients and 178 elderly patients were enrolled. On multivariate analysis, young patients exhibited significantly more often an infratentorial hematoma location, excessive alcohol consumption, and high body mass index (BMI), but less frequent systemic hypertension. There was no statistical difference between the two groups in 1-month mortality (17.46% and 18.01% for young and elderly patients, respectively), but the favorable functional outcome based on modified Rankin scale score of 0 or 1 was significantly different between the two groups (favorable outcome in 51.79% and 29.93% of patients, respectively). Predictors of 1-month mortality was the presence of herniation in the young group, and lower Glasgow Coma Scale score, renal or heart disease, and leukocytosis (WBC > 10,000) in the elderly group. Lower National Institutes Health Stroke Scale score was associated with favorable functional outcome in both groups. Nontraumatic intracerebral hemorrhage in younger patients appears to be associated with excessive alcohol consumption and high BMI. Younger patients had similar short-term mortality but more favorable functional outcome than the elderly.

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Acknowledgments

We would like to thank So Young Park, Byung Min Kim, Jae Min Lee, and Young Nam Kim for assistance with this study.

Funding

This study was supported by Hallym University Research Fund 2017 (HURF-2017-04).

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Authors and Affiliations

  1. Department of Neurosurgery, Ewha Womans University Medical Center, College of Medicine, Ewha Womans University, Seoul, Republic of Korea

    Na Rae Yang

  2. Department of Neurosurgery, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro, Dongan-gu, Anyang, 14068, Gyeonggi-do, Republic of Korea

    Ji Hee Kim, Jun Hyong Ahn, Jae Keun Oh, In Bok Chang & Joon Ho Song

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  1. Na Rae Yang
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  2. Ji Hee Kim
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Corresponding author

Correspondence to Ji Hee Kim.

Ethics declarations

This study was approved by the Institutional Review Board (IRB) of the local hospital (IRB No. 2019-01-008-001) and carried out in accordance with the Declaration of Helsinki. Informed consent was waived by the IRB as this was a recording-based study with no patient contact.

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Yang, N.R., Kim, J.H., Ahn, J.H. et al. Is nontraumatic intracerebral hemorrhage different between young and elderly patients?. Neurosurg Rev 43, 781–791 (2020). https://doi.org/10.1007/s10143-019-01120-5

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  • DOI: https://doi.org/10.1007/s10143-019-01120-5

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