Abstract
Spontaneous Intracerebral Haemorrhage (SICH) in young adult occurs due to multiple risk factors. The purpose of the present study was to determine the aetiological factors of spontaneous intracerebral haemorrhage in the young adult patients. This case control study was carried out in the Department of Neurology, Department of Neurosurgery and Department of Internal Medicine at Dhaka Medical College Hospital, Dhaka from September 2010 to August 2011 for a period of one (01) year. Patients aged 15 to 45 years who presented with spontaneous intracerebral haemorrhage were taken as case (Group A) and those more than 45 years of age with spontaneous intracerebral haemorrhage were taken as control (Group B). All the aetiological factors were recorded in a predesigned data sheet. A total of 430 patients with clinical feature of stroke were admitted through emergency and outpatient department during the study period, of which 152(35.34%) patients had spontaneous intracerebral haemorrhage. Based on the inclusion and exclusion criteria 35 patients were recruited from 15-45 years age range as case and 25 patients were recruited as control. The risk factors of SICH in younger patients were arteriovenous malformation (45.7%), toxaemia of pregnancy (31.4%), hypertension (17.1%), cavernous angioma (2.9%), bleeding disorder (2.9%) and coagulation disorder (2.9%). In patients >45 years most of the ICH was due to HTN (52%) followed by arteriovenous malformation (20%). In conclusion arteriovenous malformation is the most common aetiological factors of young stroke patients followed by hypertension and toxaemia of pregnancy.
Highlights
Spontaneous Intracerebral Hemorrhages (SICH) account for approximately 10% of all stroke cases (Mohr et al, 1978)
Patients with the age of 15 to 45 years with the clinical features of spontaneous intracerebral hemorrhage confirmed by CT-scan were taken as case (Group A) and more than 45 years of age with intracerebral haemorrhage confirmed by CT-scan were taken as control (Group B)
Among these 152 patients, 50(32.9%) patients were in the 15-45 years of age group of which 2 patients died before the investigation for the aetiological search was completed, 9 patients were unwilling to participate in this study and 4 patients were unable to undergo the thorough investigations required for etiological search
Summary
Spontaneous Intracerebral Hemorrhages (SICH) account for approximately 10% of all stroke cases (Mohr et al, 1978). The frequency of ICH among a series of stroke in young adults varies from 0.7 to 40% (Nencini et al, 1988; Bevan et al, 1990a). The etiologic spectrum of ICH in young people is different than that in the older individuals and includes vascular malformations (Toffol et al, 1987a), hypertension (Fuh et al, 1994) and drug use (Caplan et al, 1982). The 30-day case mortality of SICH is 40 to 50% (Broderick, 1994). Many of the patients who survive become disabled for the rest of their life Whenever it occurs in younger persons, they may have a longer period of time to live with their disability and this increases the risk of other medical complications among these patients.
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