Background: Spontaneous intracerebral hemorrhage (ICH) is a major cause of stroke-related morbidity and mortality, contributing to a substantial proportion of cases worldwide. Outcomes remain poor despite medical and surgical advances, highlighting the importance of identifying modifiable risk factors and reliable prognostic indicators. Objective: To evaluate the clinical, radiological, and demographic risk factors associated with spontaneous ICH and identify predictors of prognosis among patients admitted to a tertiary care hospital in South India. Methodology: A prospective observational study was conducted on 40 patients with confirmed spontaneous ICH admitted to the Emergency Department of Mahatma Gandhi Memorial Hospital, Warangal. Data were collected on demographic variables, clinical presentation, risk factors (e.g., hypertension, alcohol, and smoking), and radiologic parameters (e.g., hematoma site, volume, and Glasgow Coma Scale (GCS) score). Outcomes were measured in terms of survival, neurological recovery, and GCS scores. Results: Hypertension was the most common risk factor, present in 28 (70%) patients. Alcohol consumption and smoking were also significantly associated with spontaneous ICH. Poor prognostic indicators included low initial GCS score, larger hematoma volume (>30 cm3), presence of intraventricular hemorrhage, hydrocephalus, and midline shift. Mortality was higher in patients over 60 years and those with thalamic or brainstem bleeds. Conclusions: Hypertension remains the primary modifiable risk factor for spontaneous ICH in this population. Initial GCS score, hematoma volume, and intraventricular extension are strong prognostic indicators. Early identification and targeted management of these factors may help improve outcomes.
Peta et al. (2025) studied this question.
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