Early hemorrhage growth in patients with intracerebral hemorrhage.
OBJECTIVE
The goal of the present study was to prospectively determine how frequently early growth of intracerebral hemorrhage occurs and whether this early growth is related to early neurological deterioration.


METHODS
We performed a prospective observational study of patients with intracerebral hemorrhage within 3 hours of onset. Patients had a neurological evaluation and CT scan performed at baseline, 1 hour after baseline, and 20 hours after baseline.


RESULTS
Substantial growth in the volume of parenchymal hemorrhage occurred in 26% of the 103 study patients between the baseline and 1-hour CT scans. An additional 12% of patients had substantial growth between the 1- and 20-hour CT scans. Hemorrhage growth between the baseline and 1-hour CT scans was significantly associated with clinical deterioration, as measured by the change between the baseline and 1-hour Glasgow Coma Scale and National Institutes of Health Stroke Scale scores. No baseline clinical or CT prediction of hemorrhage growth was identified.


CONCLUSIONS
Substantial early hemorrhage growth in patients with intracerebral hemorrhage is common and is associated with neurological deterioration. Randomized treatment trials are needed to determine whether this early natural history of ongoing bleeding and frequent neurological deterioration can be improved.
Brott
T
T
University of Cincinnati Medical Center, Department of Neurology, OH 45267-0525, USA.
Broderick
J
J
Kothari
R
R
Barsan
W
W
Tomsick
T
T
Sauerbeck
L
L
Spilker
J
J
Duldner
J
J
Khoury
J
J
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001921:Brain / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007629:Kentucky; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D014057:Tomography, X-Ray Computed