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Incidence, risk factors, etiology, severity and short‐term outcome of non‐traumatic intracerebral hemorrhage in young adults
Author(s) -
Koivunen R.J.,
Satopää J.,
Meretoja A.,
Strbian D.,
Haapaniemi E.,
Niemelä M.,
Tatlisumak T.,
Putaala J.
Publication year - 2015
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12543
Subject(s) - medicine , interquartile range , etiology , intracerebral hemorrhage , incidence (geometry) , pediatrics , young adult , neuroradiology , stroke (engine) , neurology , confidence interval , neurosurgery , surgery , subarachnoid hemorrhage , mechanical engineering , physics , psychiatry , optics , engineering
Background and purpose Intracerebral hemorrhage ( ICH ) is a common and severe form of stroke but is scarcely studied in young adults. Our aim was to study risk factors, clinical presentation and early mortality of ICH in the young and compare these features with older patients. Methods All consecutive patients aged between 16 and 49 diagnosed with a first‐ever ICH at the D epartments of N eurology or N eurosurgery of the H elsinki U niversity C entral H ospital between J anuary 2000 and M arch 2010 ( n = 336) were analyzed retrospectively. Comparisons were performed amongst demographic subgroups and with patients over 49 years of age enrolled between J anuary 2005 and M arch 2010 ( n = 921). Results In the young patients, median age was 42 years (interquartile range 34–47), 59.5% were male, and annual incidence was 4.9 (95% confidence interval 4.5–5.3) per 100 000. The most prevalent risk factors were hypertension (29.8%) and smoking (22.3%). Compared with older patients hypertensive microangiopathy was less common (25.0% vs. 34.3%, P = 0.002) and structural lesions more common (25.0% vs. 4.9%, P < 0.001) assumed etiologies of ICH . The cause remained elusive in 32.1% of all young patients and in 22.5% of those who underwent magnetic resonance imaging and any angiography ( n = 89, P = 0.023). Three‐month mortality rate was lower in young patients compared with older ones (17.0% vs. 32.7%, P < 0.001). Hematoma volumes were similar across all ages ( P = 0.324) and independently predicted mortality in older patients but not in the young. Conclusions Intracerebral hemorrhage ( ICH ) in the young appears less fatal and has a different spectrum of causes and factors associated with short‐term mortality than for the elderly.