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Erschienen in: Journal of Neurology 11/2014

01.11.2014 | Original Communication

Clinical characteristics and outcome of intracerebral hemorrhage in young adults

verfasst von: Loes CA Rutten-Jacobs, Noortje AM Maaijwee, Renate M. Arntz, Hennie C. Schoonderwaldt, Lucille D. Dorresteijn, Ewoud J. van Dijk, Frank-Erik de Leeuw

Erschienen in: Journal of Neurology | Ausgabe 11/2014

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Abstract

Data on determinants of prognosis after intracerebral hemorrhage (ICH) in young adults are scarce. Our aim was to identify clinical determinants of prognosis after ICH in adults aged 18–50. We investigated 98 consecutive patients with an ICH, aged 18–50 years, admitted to our hospital between 1980 and 2010. Collected ICH characteristics included presenting symptoms, etiology, location, severity and Glasgow Coma Scale (GCS). Outcomes were case-fatality (death within 30 days), poor functional outcome (modified Rankin Scale >2), long-term mortality and recurrent ICH. We assessed discriminatory power of factors associated with case-fatality [area under receiver operating curve (AUC)]. Case-fatality was 20.4 % (n = 20) and well predicted by the GCS (AUC 0.83). Among 30-day survivors, a poor functional outcome at discharge was present in 51.3 %. During a mean follow-up of 11.3 years mortality was only increased in patients aged 40–50 years [standardized mortality ratio 4.8 (95 % CI 2.3–8.6)], but not in patients aged 18–40 years. Recurrent ICH occurred in 6 patients [10-year cumulative incidence 12.2 % (95 % CI 1.5–22.9 %)], all with the index ICH attributable to structural vascular malformations. Prognosis after ICH in young adults is poor, mainly due to high case-fatality, that is well predicted by the GCS. An exception is 30-day survivors <40 years, who have a similar risk of dying as the general population. Recurrence risk is especially present in patients with structural vascular malformations, whereas risk seems to be very low in other patients.
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Metadaten
Titel
Clinical characteristics and outcome of intracerebral hemorrhage in young adults
verfasst von
Loes CA Rutten-Jacobs
Noortje AM Maaijwee
Renate M. Arntz
Hennie C. Schoonderwaldt
Lucille D. Dorresteijn
Ewoud J. van Dijk
Frank-Erik de Leeuw
Publikationsdatum
01.11.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology / Ausgabe 11/2014
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-014-7469-6

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