Long-term prognosis after recovery from primary intracerebral hemorrhage

Abstract

Patients who recovered from a primary intracerebral hemorrhage had a 2.1% to 5.9% annual rate of recurrence, vascular death, or vascular events. Age of 65 years or older more than doubled the risk of recurrence, vascular event, or death. The risk of vascular events in men was increased twofold.

Analysis of Predictive Factors of Mortality in Hemorrhagic Stroke Patients at Soebandi Hospital Jember

“…Setianto et al (2014) menyatakan bahwa rerata usia subyek penelitian dengan keluaran klinis buruk selama penelitian adalah 59 tahun. Usia tua merupakan prediktor yang kuat terhadap prognosis buruk stroke hemoragik termasuk angka rekurensi, perburukan klinis dan mortalitas (Vermeer et al, 2002). Stroke umumnya terjadi pada lanjut usia dan terdapat peningkatan kejadian serangan stroke pada usia di atas 55 tahun, Hal ini dikarenakan adanya Go et al (2013) bahwa GCS awal masuk >8 mempunyai prediksi luaran baik, sedangkan GCS <8 merupakan prediktor luaran yang buruk yaitu mortalitas dalam 2 hari perawatan.…”

Therapeutic Strategies in Acute Intracerebral Hemorrhage

“…The rate of recurrent hemorrhage is approximately 2% per patient-year [129,130]. Several risk factors for recurrent ICH have been identified during the years, including older age [130], hypertension [129], lobar ICH location [131], possession of the apolipoprotein E ε2, or ε4 allele [132], and more microbleeds on gradient recalled echo MRI [51].…”

“…Several risk factors for recurrent ICH have been identified during the years, including older age [130], hypertension [129], lobar ICH location [131], possession of the apolipoprotein E ε2, or ε4 allele [132], and more microbleeds on gradient recalled echo MRI [51]. Of these, hypertension is an important and modifiable risk factor for recurrent hemorrhage.…”

“…However, oral anticoagulation use after ICH is associated with a threefold increase in recurrent ICH [130]. It is likely that some patients can be safely re-anticoagulated (such as those with hypertensive ICH in whom good blood pressure control can be achieved), but some cannot, and the appropriate timeframe is likely a function of their risk [133].…”

Restarting oral anticoagulants after intracerebral hemorrhage: pros

“…Moreover, one should keep in mind that a post-ICH patient is frequently bed-ridden, which further increases the risk for VTE regardless of and in addition to the underlying condition that initially required treatment with anticoagulants. On the other hand, the risk of ICH recurrence seems to be associated with ICH location [1], age [2], apolipoprotein E e2 or e4 alleles [3] and presence of microbleeds on T2*-weighted gradient-echo MRI [4].…”