Md Shoriful Islam1 , Richmond Ronald Gomes*2 , Monjur Hasan FM3
1DNCC dedicated COVID Hospital Dhaka , Dhaka, Bangladesh 2 Ad-Din Women’s Medical College Hospital, Dhaka, Bangladesh 3 Ad-Din Sakina Women’s Medical College Hospital, Jashore, BangladeshFulltext PDF
Spontaneous Intracerebral Hemorrhage (ICH) has remained is the least treatable form of stroke despite recent improvements in medical treatment. Treatment usually supportive and medical such as ventilatory support, blood pressure reduction, osmotherapy, fever control, seizure control and nutritional support and treatment of comorbid conditions. This study was carried out to see demographic variability, clinical presentation, causes and outcome of spontaneous intracerebral hemorrhage. Methods and Materials: This were a cross sectional observational prospective in study on 50 spontaneous ICH patients admitted in Medicine department of Khulna Medical College Hospital from November 2020 to April 2021. Result: The study showed that spontaneous ICH was most common in between 41 to 70 years. Their age frequency was 14 (28%) in 41 to 50 years, 15 (30%) in 51 to 60 years, 12 (24%) in 61 to 70 years, 5 (10%) in 71 to 80 years and 4 (8%) in more than 81 years age group. Among the patients, 64% (32) were male and 36% (18) were female. Hemorrhage in the right cerebral hemisphere was in 52% (26) & in left cerebral hemisphere in 48% (24) patients. Hemorrhage was more common in the basal ganglia 60% (30), thalamus 14% (7), lobar in 14% (7), pontine in 6% (3), internal capsule in 6% (3) patients. Ventricular hemorrhage was present in 36% (18) & absent in 64% (32) patients. Among 50 cases 88% (44) survived and died 12% (6) and good recovery was in 24% (12), moderately disable 22% (11) severely disable 26% (13), vegetative 16% (8) and death 12% (6) patients. Among the cases GCS Score 8 or less 30% were alive and 12% died and. Among those cases Glasgow coma scale score 9 or more all were alive. Among patients with Glasgow coma scale score 8 or less good recovery was (00), moderately disable (03), severely disable (04), vegetative (08), dead (06). There were statistically significant association (p-value =0.002) between low (8 or less) Glasgow coma scale Score and outcome of patients with spontaneous ICH. Among patients with Glasgow coma scale score 9 or more good recovery (12), moderately disable (08), severely disable (09), vegetative (00), dead (00). Among 36% (18) patients of ventricular hemorrhage 26% (13) were alive and 10% (05) died. Among 64% (32) patients without ventricular hemorrhage 62% (31) were alive and 2% (01) died. There is statistically significant association (p-value =0.01) between ventricular hemorrhage and outcome of patients with spontaneous ICH. Conclusion: Spontaneous ICH is common in Indian subcontinent. As death occur due to ICH itself, associated co morbidities or due to complications, management in stroke care unit, High dependency unit and Intensive care unit is required.
Spontaneous; Intracerebral Hemorrhage; Osmotherapy; Seizure; Glasgow coma scale
Shoriful Islam Md, Gomes RR, Monjur Hasan FM. Demographic Pro iles, Distribution of Lesion on CT Brain and Outcome in Patients with Spontaneous Intracerebral Hemorrhage (ICH) in a Tertiary Care Hospital: A Cross Sectional Study. Ann Clin Med Res. 2021; 2(4): 1034..