title: Spontaneous intracerebral hemorrhage in Mexico: results from a Multicenter Nationwide Hospital-based Registry on Cerebrovascular Disease (RENAMEVASC).
abstract: BACKGROUND
  Scarce information exists on intracerebral hemorrhage (ICH) in Latin America, and the existent is derived from single-center registries with non-generalizable conclusions. The aim of this study is to describe the frequency, etiology, management and outcome of ICH in Mexico.
  
  
  METHODS
  We studied consecutive patients with ICH pertaining to the National Multicenter Registry on Cerebro-vascular Disease (RENAMEVASC), conducted in 25 centers from 14 states of Mexico. The Intracerebral Hemorrhage Grading Scale (ICH-GS) at admission was used to assess prognosis at 30 days follow-up.
  
  
  RESULTS
  Of 2,000 patients with acute cerebrovascular disease registered in RENAMEVASC, 564 (28%) had primary ICH (53% women; median age: 63 years; interquartile range: 50-75 years). Hypertension (70%), vascular malformations (7%) and amyloid angiopathy (4%) were the main etiologies. In 10% of cases etiology could not be determined. Main ICH locations were basal ganglia (50%), lobar (35%) and cerebellum (5%). Irruption into the ventricular system occurred in 43%. Median score of ICH-GS was 8 points: 49% had 5-7 points, 37% had 8-10 points and 15% had 11-13 points. The 30-day case fatality rate was 30%, and 31% presented severe disability. The 30-day survival was 92% for patients with ICH-GS 5-7 points, whereas it decreased to 27% in patients with ICH-GS 11-13 points.
  
  
  CONCLUSIONS
  In Mexico, ICH represents about a third of the forms of acute cerebrovascular disease, and the majority of patients present severe disability or death at 30 days of follow-up. Hypertension is the main cause; hence, control of this important cardiovascular risk factor should reduce the health burden of ICH.
authors: Neurology and Neurosurgery Department, Hospital Civil Fray Antonio Alcalde, Guadalajara, Jalisco, México. jorulej-1nj@prodigy.net.mx
authors: José L
authors: JL
authors: Ruiz-Sandoval
authors: Erwin
authors: E
authors: Chiquete
authors: Alejandra
authors: A
authors: Gárate-Carrillo
authors: Ana
authors: A
authors: Ochoa-Guzmán
authors: Antonio
authors: A
authors: Arauz
authors: Carolina
authors: C
authors: León-Jiménez
authors: Karina
authors: K
authors: Carrillo-Loza
authors: Luis M
authors: LM
authors: Murillo-Bonilla
authors: Jorge
authors: J
authors: Villarreal-Careaga
authors: Fernando
authors: F
authors: Barinagarrementería
authors: Carlos
authors: C
authors: Cantú-Brito
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D016896:Treatment Outcome