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Stroke, Vol 24, 987-993, Copyright © 1993 by American Heart Association


ARTICLES

Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality

JP Broderick, TG Brott, JE Duldner, T Tomsick and G Huster
Department of Neurology, University of Cincinnati Medical Center, OH 45267-0525.

BACKGROUND AND PURPOSE: The aim of this study was to determine the 30- day mortality and morbidity of intracerebral hemorrhage in a large metropolitan population and to determine the most important predictors of 30-day outcome. METHODS: We reviewed the medical records and computed tomographic films for all cases of spontaneous intracerebral hemorrhage in Greater Cincinnati during 1988. Independent predictors of 30-day mortality were determined using univariate and multivariate statistical analyses. RESULTS: The 30-day mortality for the 188 cases of intracerebral hemorrhage was 44%, with half of deaths occurring within the first 2 days of onset. Volume of intracerebral hemorrhage was the strongest predictor of 30-day mortality for all locations of intracerebral hemorrhage. Using three categories of parenchymal hemorrhage volume (0 to 29 cm3, 30 to 60 cm3, and 61 cm3 or more), calculated by a quick and easy-to-use ellipsoid method, and two categories of the Glasgow Coma Scale (9 or more and 8 or less), 30-day mortality was predicted correctly with a sensitivity of 96% and a specificity of 98%. Patients with a parenchymal hemorrhage volume of 60 cm3 or more on their initial computed tomogram and a Glasgow Coma Scale score of 8 or less had a predicted 30-day mortality of 91%. Patients with a volume of less than 30 cm3 and a Glasgow Coma Scale score of 9 or more had a predicted 30-day mortality of 19%. Only one of the 71 patients with a volume of parenchymal hemorrhage of 30 cm3 or more could function independently at 30 days. CONCLUSIONS: Volume of intracerebral hemorrhage, in combination with the initial Glasgow Coma Scale score, is a powerful and easy-to-use predictor of 30-day mortality and morbidity in patients with spontaneous intracerebral hemorrhage.


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Use of the Original, Modified, or New Intracerebral Hemorrhage Score to Predict Mortality and Morbidity After Intracerebral Hemorrhage
Stroke, July 1, 2003; 34(7): 1717 - 1722.
[Abstract] [Full Text] [PDF]


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NeurologyHome page
P. M. Vespa, K. O'Phelan, M. Shah, J. Mirabelli, S. Starkman, C. Kidwell, J. Saver, M. R. Nuwer, J. G. Frazee, D. A. McArthur, et al.
Acute seizures after intracerebral hemorrhage: A factor in progressive midline shift and outcome
Neurology, May 13, 2003; 60(9): 1441 - 1446.
[Abstract] [Full Text] [PDF]


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StrokeHome page
S. A. Mayer
Ultra-Early Hemostatic Therapy for Intracerebral Hemorrhage
Stroke, January 1, 2003; 34(1): 224 - 229.
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StrokeHome page
J. M. Gebel Jr, E. C. Jauch, T. G. Brott, J. Khoury, L. Sauerbeck, S. Salisbury, J. Spilker, T. A. Tomsick, J. Duldner, and J. P. Broderick
Relative Edema Volume Is a Predictor of Outcome in Patients With Hyperacute Spontaneous Intracerebral Hemorrhage
Stroke, November 1, 2002; 33(11): 2636 - 2641.
[Abstract] [Full Text] [PDF]


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NeurologyHome page
A. A. Rabinstein, J. L. Atkinson, and E. F.M. Wijdicks
Emergency craniotomy in patients worsening due to expanded cerebral hematoma: To what purpose?
Neurology, May 14, 2002; 58(9): 1367 - 1372.
[Abstract] [Full Text] [PDF]


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NeurologyHome page
J. Castillo, A. Davalos, J. Alvarez-Sabin, J. M. Pumar, R. Leira, Y. Silva, J. Montaner, and C.S. Kase
Molecular signatures of brain injury after intracerebral hemorrhage
Neurology, February 26, 2002; 58(4): 624 - 629.
[Abstract] [Full Text] [PDF]


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StrokeHome page
G. Xi, Y. Hua, R. R. Bhasin, S. R. Ennis, R. F. Keep, and J. T. Hoff
Mechanisms of Edema Formation After Intracerebral Hemorrhage: Effects of Extravasated Red Blood Cells on Blood Flow and Blood-Brain Barrier Integrity
Stroke, December 1, 2001; 32(12): 2932 - 2938.
[Abstract] [Full Text] [PDF]


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NeurologyHome page
P. Lyden, M. Jacoby, J. Schim, G. Albers, P. Mazzeo, T. Ashwood, A. Nordlund, and T. Odergren
The Clomethiazole Acute Stroke Study in tissue-type plasminogen activator-treated stroke (CLASS-T): Final results
Neurology, October 9, 2001; 57(7): 1199 - 1205.
[Abstract] [Full Text] [PDF]


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NeurologyHome page
O. Surma-aho, M. Niemela, J. Vilkki, M. Kouri, A. Brander, O. Salonen, A. Paetau, M. Kallio, J. Pyykkonen, LicPhil;, and J. Jaaskelainen
Adverse long-term effects of brain radiotherapy in adult low-grade glioma patients
Neurology, May 22, 2001; 56(10): 1285 - 1290.
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NEJMHome page
A. I. Qureshi, S. Tuhrim, J. P. Broderick, H. H. Batjer, H. Hondo, and D. F. Hanley
Spontaneous Intracerebral Hemorrhage
N. Engl. J. Med., May 10, 2001; 344(19): 1450 - 1460.
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StrokeHome page
J. C. Hemphill III, D. C. Bonovich, L. Besmertis, G. T. Manley, S. C. Johnston, and S. Tuhrim
The ICH Score : A Simple, Reliable Grading Scale for Intracerebral Hemorrhage Editorial Comment: A Simple, Reliable Grading Scale for Intracerebral Hemorrhage
Stroke, April 1, 2001; 32(4): 891 - 897.
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NeurologyHome page
K.J. Becker, A.B. Baxter, W.A. Cohen, H.M. Bybee, D.L. Tirschwell, D.W. Newell, H.R. Winn, and W.T. Longstreth Jr.
Withdrawal of support in intracerebral hemorrhage may lead to self-fulfilling prophecies
Neurology, March 27, 2001; 56(6): 766 - 772.
[Abstract] [Full Text] [PDF]


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StrokeHome page
J. Berwaerts, R. S. Dijkhuizen, O. J. Robb, and J. Webster
Prediction of Functional Outcome and In-Hospital Mortality After Admission With Oral Anticoagulant-Related Intracerebral Hemorrhage
Stroke, November 1, 2000; 31(11): 2558 - 2562.
[Abstract] [Full Text] [PDF]


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StrokeHome page
T. G. Phan, M. Koh, R. A. Vierkant, and E. F.M. Wijdicks
Hydrocephalus Is a Determinant of Early Mortality in Putaminal Hemorrhage
Stroke, September 1, 2000; 31(9): 2157 - 2162.
[Abstract] [Full Text] [PDF]


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StrokeHome page
J. M. Montes, J. H. Wong, P. B. Fayad, and I. A. Awad
Stereotactic Computed Tomographic-Guided Aspiration and Thrombolysis of Intracerebral Hematoma : Protocol and Preliminary Experience
Stroke, April 1, 2000; 31(4): 834 - 840.
[Abstract] [Full Text] [PDF]


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NeurologyHome page
S. Schwarz, K. Hafner, A. Aschoff, and S. Schwab
Incidence and prognostic significance of fever following intracerebral hemorrhage
Neurology, January 25, 2000; 54(2): 354 - 354.
[Abstract] [Full Text] [PDF]


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StrokeHome page
M. D. Hill, F. L. Silver, P. C. Austin, and J. V. Tu
Rate of Stroke Recurrence in Patients With Primary Intracerebral Hemorrhage
Stroke, January 1, 2000; 31(1): 123 - 127.
[Abstract] [Full Text] [PDF]


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StrokeHome page
K. J. Becker, A. B. Baxter, H. M. Bybee, D. L. Tirschwell, T. Abouelsaad, and W. A. Cohen
Extravasation of Radiographic Contrast Is an Independent Predictor of Death in Primary Intracerebral Hemorrhage
Stroke, October 1, 1999; 30(10): 2025 - 2032.
[Abstract] [Full Text] [PDF]


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StrokeHome page
M. Zuccarello, T. Brott, L. Derex, R. Kothari, L. Sauerbeck, J. Tew, H. Van Loveren, H.-S. Yeh, T. Tomsick, A. Pancioli, et al.
Early Surgical Treatment for Supratentorial Intracerebral Hemorrhage : A Randomized Feasibility Study
Stroke, September 1, 1999; 30(9): 1833 - 1839.
[Abstract] [Full Text] [PDF]


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NeurologyHome page
D. F. Edwards, H. Hollingsworth, A. R. Zazulia, and M. N. Diringer
Artificial neural networks improve the prediction of mortality in intracerebral hemorrhage
Neurology, July 1, 1999; 53(2): 351 - 351.
[Abstract] [Full Text] [PDF]


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StrokeHome page
A. R. Zazulia, M. N. Diringer, C. P. Derdeyn, and W. J. Powers
Progression of Mass Effect After Intracerebral Hemorrhage
Stroke, June 1, 1999; 30(6): 1167 - 1173.
[Abstract] [Full Text] [PDF]


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J. Neurol. Neurosurg. PsychiatryHome page
K. D Flemming, E. F M Wijdicks, E. K S. Louis, and H. Li
Predicting deterioration in patients with lobar haemorrhages
J. Neurol. Neurosurg. Psychiatry, May 1, 1999; 66(5): 600 - 605.
[Abstract] [Full Text]


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Am. J. Neuroradiol.Home page
R. Bakshi, S. Kamran, P. R. Kinkel, V. E. Bates, L. L. Mechtler, V. Janardhan, S. L. Belani, and W. R. Kinkel
Fluid-Attenuated Inversion-Recovery MR Imaging in Acute and Subacute Cerebral Intraventricular Hemorrhage
AJNR Am. J. Neuroradiol., April 1, 1999; 20(4): 629 - 636.
[Abstract] [Full Text]


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NeurologyHome page
C. D. Bushnell, B. G. Phillips-Bute, D. T. Laskowitz, J. R. Lynch, V. Chilukuri, and C. O. Borel
Survival and outcome after endotracheal intubation for acute stroke
Neurology, April 1, 1999; 52(7): 1374 - 1374.
[Abstract] [Full Text] [PDF]


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NeurologyHome page
A. I. Qureshi, D. A. Wilson, D. F. Hanley, and R. J. Traystman
No evidence for an ischemic penumbra in massive experimental intracerebral hemorrhage
Neurology, January 1, 1999; 52(2): 266 - 266.
[Abstract] [Full Text]


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StrokeHome page
G. Xi, K. R. Wagner, R. F. Keep, Y. Hua, G. M. de Courten-Myers, J. P. Broderick, T. G. Brott, J. T. Hoff, and J. P. Muizelaar
Role of Blood Clot Formation on Early Edema Development After Experimental Intracerebral Hemorrhage • Editorial Comment
Stroke, December 1, 1998; 29(12): 2580 - 2586.
[Abstract] [Full Text] [PDF]


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CirculationHome page
M. A. Sloan, C. A. Sila, K. W. Mahaffey, C. B. Granger, W. T. Longstreth Jr, P. Koudstaal, H. D. White, J. M. Gore, M. L. Simoons, W. D. Weaver, et al.
Prediction of 30-Day Mortality Among Patients With Thrombolysis-Related Intracranial Hemorrhage
Circulation, October 6, 1998; 98(14): 1376 - 1382.
[Abstract] [Full Text] [PDF]


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StrokeHome page
J. M. Gebel, C. A. Sila, M. A. Sloan, C. B. Granger, J. P. Weisenberger, C. L. Green, E. J. Topol, and K. W. Mahaffey
Comparison of the ABC/2 Estimation Technique to Computer-Assisted Volumetric Analysis of Intraparenchymal and Subdural Hematomas Complicating the GUSTO-1 Trial
Stroke, September 1, 1998; 29(9): 1799 - 1801.
[Abstract] [Full Text] [PDF]


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StrokeHome page
M. N. Diringer, D. F. Edwards, and A. R. Zazulia
Hydrocephalus: A Previously Unrecognized Predictor of Poor Outcome From Supratentorial Intracerebral Hemorrhage
Stroke, July 1, 1998; 29(7): 1352 - 1357.
[Abstract] [Full Text] [PDF]


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StrokeHome page
S. Kazui, K. Minematsu, H. Yamamoto, T. Sawada, and T. Yamaguchi
Predisposing Factors to Enlargement of Spontaneous Intracerebral Hematoma
Stroke, December 1, 1997; 28(12): 2370 - 2375.
[Abstract] [Full Text]


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StrokeHome page
R. Fogelholm, S. Avikainen, and K. Murros
Prognostic Value and Determinants of First-Day Mean Arterial Pressure in Spontaneous Supratentorial Intracerebral Hemorrhage
Stroke, July 1, 1997; 28(7): 1396 - 1400.
[Abstract] [Full Text]


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StrokeHome page
T. Brott, J. Broderick, R. Kothari, W. Barsan, T. Tomsick, L. Sauerbeck, J. Spilker, J. Duldner, and J. Khoury
Early Hemorrhage Growth in Patients With Intracerebral Hemorrhage
Stroke, January 1, 1997; 28(1): 1 - 5.
[Abstract] [Full Text]


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StrokeHome page
L. Mayfrank, J. Kissler, R. Raoofi, P. Delsing, J. Weis, W. Kuker, J.M. Gilsbach, and J. P. Muizelaar
Ventricular Dilatation in Experimental Intraventricular Hemorrhage in Pigs: Characterization of Cerebrospinal Fluid Dynamics and the Effects of Fibrinolytic Treatment
Stroke, January 1, 1997; 28(1): 141 - 148.
[Abstract] [Full Text]


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StrokeHome page
S. Kazui, H. Naritomi, H. Yamamoto, T. Sawada, and T. Yamaguchi
Enlargement of Spontaneous Intracerebral Hemorrhage: Incidence and Time Course
Stroke, October 1, 1996; 27(10): 1783 - 1787.
[Abstract] [Full Text]