Spontaneous intracranial hemorrhage in cirrhotic patients.
OBJECTIVE
The major characteristics of spontaneous intracranial hemorrhage (SICH) in cirrhotic patients have not been completely defined. Cirrhotic patients with SICH were thus analyzed in an effort to better understand the risk factors for SICH and predict patient outcomes.


METHODS
From 1997 to 2006, 4515 hospitalized cirrhotic patients were recruited, with a focus on 36 cirrhotic patients with SICH who had no history of cerebral vascular accidents, head injuries, or cerebral arteriovenous malformations. The patient characteristics, severity of cirrhosis, location of the hematoma, and prognosis were analyzed.


RESULTS
Of the patients, 78% were males, 72% consumed alcohol, and 81% had a mild-to-moderate degree of cirrhosis. The overall incidence of SICH was related to the etiology of cirrhosis as follows: virus-related cirrhosis (0.3%), alcohol-related cirrhosis (1.9%), and combined virus- and alcohol-related cirrhosis (3%). The outcome of patients with SICH was associated with the size of the hematoma (P<0.005), the initial Glasgow Coma Scale score (P<0.05), the Child-Pugh classification (P=0.05), and the serum total bilirubin level (P<0.05).


CONCLUSIONS
SICH occurs primarily in young males with mild-to-moderate alcoholic cirrhosis of the liver. The etiology of cirrhosis is related to the incidence of SICH, but not to the patient outcome. The severity of liver cirrhosis is associated with patient outcome, but not the incidence of SICH.
Huang
Hsin-Hung
HH
Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, 325, Sec 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan, ROC.
Lin
Hsuan-Hwai
HH
Shih
Yu-Lueng
YL
Chen
Peng-Jen
PJ
Chang
Wei-Kuo
WK
Chu
Heng-Cheng
HC
Chao
You-Chen
YC
Hsieh
Tsai-Yuan
TY
D000328:Adult; D017668:Age of Onset; D000368:Aged; D001921:Brain / Q000473:pathology; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000209:etiology*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome