Spontaneous intraparenchymal hemorrhage in young adults: Cross-sectional study

Abstract

BackgroundVery few studies on young adult Spontaneous Intraparenchymal Hematoma (SIH) were reported in the literature. The characteristics of SIH differ between young and elderly patients; most SIH is attributed to high blood pressure (HBP). ObjectivesWe aim to present the epidemiological, clinical, and etiology profile of young adults with SIH, and their intra-hospital short-term outcomes. MethodsThis is a cross-sectional study conducted in our institution from January 2021 to January 2022. Patients admitted in emergency and managed for SIH were recorded prospectively. ResultsFifty-six patients aged between 17 and 65 years old were included. The most common etiology was high blood pressure (44.6%, n = 25). Forty-eight (85.7%) patients were admitted with an ICH score <4. Most localizations of the SIH were deep regions (44.6%, n = 25). Thirty-seven patients (66.1%) received only medical treatment; EVD was performed in 14.3% and craniotomy in 12.5%. Unfortunately, 37 patients (66.07%) died, and 19 (33.92%) patients were discharged alive. High blood pressure was associated with high mortality rates (P = 0.09), the localization of the SIH did not significantly influence the mortality rate (P = 0.29). Age did not influence the mortality rate (AUC = 0.50, P = 0.971). Patients between the ages of 17 to 55 years had significantly less HBP (60.7%) than patients between ages of 56 to 65 years (75%) (P < 0.001), in contrast the patients between the age <46 years has significantly most vascular malformation than those >45 years old (11.1 vs 6.4 %, P <0.001). ConclusionPrevention or early detection of risk factors such as HBP for SIH must be implemented in young adults.