Prediction of clinical outcome in acute hemorrhagic stroke from a single CT scan on admission

Abstract

Background:From a single CT scan in primary intracerebral hemorrhage (ICH), clinical outcome can be assessed on admission by using the CT scan parameters.Aims:The study aims to find out how hematoma volume, location of stroke, midline shift, intraventricular extension of bleed and ventricle compression influence the clinical outcome in patients with acute ICH.Materials and Methods:Non-contrast CT scan was done on admission in hospital for every patient with acute hemorrhagic stroke and was analyzed accordingly. Clinical assessments were done in National Institute of Health Stroke Scale (NIHSS). Chi-square test and multiple logistic regression analysis were used for statistical analysis.Results:Mean hematoma volume associated with death before 30 days is 33.16 cm3 (P < 0.0001), with survived after 30 days is 15.45 cm3 (P < 0.0001), with NIHSS score ≥16 is 29.03 cm3 (P < 0.0001) and with NIHSS score <16 is 13.69 cm3 (P < 0.0001). Independent poor prognostic factors were hematoma volume > 30 cm3 (OR = 27.857), brain stem hemorrhage (OR = 6.000), intraventricular extension of bleed from other location (OR = 7.846), presence of ventricular compression alone (OR = 2.700) and in combination with midline shift of ≥ 5 mm (OR = 2.124).Conclusions:From a single CT scan during hospital admission, mortality and morbidity in next 30 days can be predicted. A hematoma volume >30 cm3, brain stem hematoma, intraventricular extension of bleed and ventricular compression along and with midline shift are associated with early mortality in ICH.

Association of C-Reactive Protein Level and Short Term Clinical Outcome among Spontaneous Intracerebral Haemorrhage Patients

“…Mean (± standard deviation) age was 64.01 ± 13.90 years. The age distribution was similar to that of most of the previous studies conducted in Bangladesh and India [12][13][14] . The youngest and oldest patients were of 20 and 80 years respectively.…”

Influence of Intracerebral Hemorrhage Location on Incidence, Characteristics, and Outcome

“…8,9 However, most ICHs are supratentorial and the influence of supratentorial ICH location on outcome remains unclear. Lobar ICH may have a better prognosis in comparison with ICH in other locations, [10][11][12][13] or it may not, [14][15][16][17][18][19][20] and the risk of recurrence may be higher after lobar ICH. 21 Determining whether risk factors and outcome differ according to ICH location has been further complicated by studies' varied definitions of ICH location.…”

Changes in volume of giant intracranial aneurysms treated by surgical strategies other than direct clipping

“…In ICH, stroke, and brain tumors, the quantification of intracranial mass effect is common since it was shown to be associated with the overall prognosis [3,8,10,12,15,22]. One established method is to measure the volume of the lesion itself over time.…”

“…Furthermore, there is uncertainty on how to best quantify changes in the mass effect GIA exert on the brain. In the field of intracerebral hemorrhage (ICH) mid-line shift (MLS) or lateral ventricle volume (LVV) have long been used as indicators of changes in mass effect [10,16].…”