A New Look at the Natural History and Clinical Features of Intracerebral Haemorrhage: A Clinical CT Scan Correlation

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Abstract
Intracerebral haemorrhage (ICH), as documented in 77 patients by computerized tomographic (CT) scans, was studied with regard to presentation, neurological features and outcome. Death occurred in 34%, a lower figure than was thought in the pre-CT scan era, and comparable to reported series in the last 10 years. Survival was more common in patients with intralobar haemorrhage, in which there was a less close association with hypertension or with coma. Intraventricular haemorrhages carried a bad prognosis with 14 deaths out of the 24 patients thus diagnosed. Eighty-eight percent of the survivors returned home, and nearly half of them had almost normal function. The main negative prognostic factors as determined by discriminant analysis were: presentation with coma over several hours, abnormalities of pupils or eye movements, inability to be mobilized after an average of 4 days, large volumes of haematoma as measured in CT scan and intraventricular bleeding. It is important to make the diagnosis in order not to give anticoagulant treatment inappropriately, and there should be awareness that ICH is more common than was previously thought.

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