Hypertensive Intracerebral Hemorrhage in Young Patients From a Tertiary Care Center in Saudi Arabia: An Observational Study

Aishah Albakr, MD; Abdullah AlFajri, MBBS; Ahmad Almatar, MBBS; Hassan A. Aldandan, MBBS; Nehad Soltan, MD; Noman Ishaque, FCPS; Azra Zafar, FCPS; Saima Nazish, FCPS; Danah AlJaafari, MD; Mona I. AlMuhaish, MD; Roaa M. AlGowiez, MD; Hosam AlJehani, MD

Prim Care Companion CNS Disord 2021;23(3):20m02768

ABSTRACT

Objective: Young patients with intracerebral hemorrhage (ICH) make up a small but important subgroup of patients with ICH. This study investigated the clinical characteristics and outcomes of hypertensive ICH in very young (18–45 years) and young (46–55 years) patients.

Methods: This was a retrospective study of patients aged 18–55 years with hypertensive ICH admitted to a hospital from April 2014 to April 2019. Clinical and radiologic features as well as long-term clinical outcomes were compared between 2 age groups: group 1 (18–45 years) and group 2 (46–55 years). Factors affecting the clinical outcome were investigated as well.

Results: Of 63 patients with hypertensive ICH, 24 (38.1%) were in group 1 (mean ± SD age of 38 ± 4.6 years), and 39 (61.9%) were in group 2 (50 ± 2.5 years). The risk factor profile was similar except for diabetes, which was more prevalent in group 1 (odds ratio [OR] = 4.65; 95% CI, 1.4–15.2). Patients in group 1 had higher mean ± SD NIH Stroke Scale scores (15.7 ± 4.6, P = .044), had lower Glasgow Coma Scale (GCS) scores (OR = 3.33; 95% CI, 1.0–10.8), were at higher risk of intubation (OR = 2.79; 95% CI, 1.1–9.9), and had higher ICH volume (21 ± 18, P = .034). Worse clinical outcome was higher in group 1 (OR = 5.14; 95% CI, 1.0–26.1). Low GCS score, mean hematoma volume, and intraventricular extension were independently associated with worse outcome.

Conclusions: Relatively young patients with hypertensive ICH have higher prevalence of diabetes and worse clinical outcome in comparison to older patients with hypertensive ICH. Such patients should be monitored and treated more aggressively.

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