Prognosis of spontaneous hemorrhagic stroke in people under 55 in Senegal, a developing country in Africa: a series of 53 cases.

Abstract

Strokes occur increasingly frequently in people aged 55 years or younger and present a problem of management and therefore of prognosis. The objective of this study was to determine the prognostic factors associated with hemorrhagic stroke in this population in Senegal. This retrospective study concerns 53 patients aged 16 to 55 years, hospitalized for hemorrhage stroke in the neurological department of Fann Teaching Hospital during 2010. The patients' mean age was 42.1 years (16 to 55 years) and the sex ratio 1.30 in favor of women. Hypertension was found in 62% of the patients, and 11% had a history of stroke. Hemiplegia was observed in 76%, associated more or less with impairment of consciousness (43%) and language (38%). Intraparenchymal hematomas were principally supratentorial (78%); only 15% were subtentorial (10% cerebellar and 5% in the brainstem). During the acute phase of hemorrhage, glycemic levels were high among one third of the patients. The mortality rate in our series was 43% and was highest among those of impaired consciousness and abnormal glycemic, cholesterol, and creatinemia levels. Neuropsychological sequelae occurred in 47% of all patients, including 83% of the survivors. Hemorrhagic stroke in people aged 55 years or younger is a public health problem. In view of the high mortality rate, effective control requires prevention of its risk factors and increased awareness of the danger of these factors and of the warning signs of stroke.