Neurosurgery notes/Vascular/Haemorrhagic diseases/Intracerebral haemorrhage (ICH)/Outcome/prognosis

Outcome/prognosis

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Intracerebral haemorrhage (ICH)

ICT score: Hemphill et al

  • ICH Score
      • Feature
      Finding
      Points
      GCS score (Table 12-1, page 279)
      3-4
      2
      ㅤ
      5-12
      1
      ㅤ
      13-15
      0
      Age*
      ≥ 80 years
      1
      ㅤ
      < 80
      0
      Location
      Infratentorial
      1
      ㅤ
      Supratentorial
      0
      ICH volume (Eq 32-1)
      ≥ 30 cc
      1
      ㅤ
      < 30 cc
      0
      Intraventricular blood
      Yes
      1
      ㅤ
      No
      0
      "ICH Score" = Total Points
      ㅤ
      0-6
      *possible bias since treatment decisions in elderly patients may have differed from younger ones
  • Mortality based on ICH Score
      • ICH Score*
      30 day mortality
      0
      0% (26 pts)
      1
      13% (32 pts)
      2
      26% (27 pts)
      3
      72% (32 pts)
      4
      97% (29 pts)
      5
      100% (6 pts)
      6
      ? 100%† (0 pts)
      *from first table
      † no pt. in the study had a score of 6, but "it is expected this would be associated with high rate of mortality"
  • ICH volume using ABC/2: in three axis.

ICH growth

  • Antiplatelet or anticoagulants
      • notion image
  • CTA: Spot sign: leaking of contrast
        • notion image

ICH and IVH

  • Bhattathiri et al 2006
    • Outcomes
      • Chance of favourable outcomes
        • No IVH 31.4%
        • Yes IVH 15.1%
          • Chance of favourable outcomes with HCP
            • 11.5%