title: Intracerebral hemorrhage with hypothyroidism.
abstract: BACKGROUND
  Hypothyroidism is associated with increased ischemic stroke risk but paradoxically results in more favorable outcomes once a stroke occurs. Whether a similar pattern emerges in patients with primary intracerebral hemorrhage (ICH) is unknown.
  
  
  METHODS
  A retrospective analysis of a prospective stroke center database was performed to analyze the clinical presentation and outcomes of hypothyroid patients with spontaneous ICH. Patients were classified into groups with no history of thyroid disease (n=491) versus those with hypothyroidism (n=72). Hypothyroid patients were further classified into patients receiving thyroid replacement on admission or those without replacement. The Glasgow Coma Scale, ICH score, and the National Institutes of Health Stroke Scale (NIHSS) were used to assess the initial severity. Outcome was assessed by admission to discharge change in the NIHSS and modified Barthel Index (mBI), in-hospital mortality, discharge disposition and mortality, and the mBI at 3 and 12 months.
  
  
  RESULTS
  There were 563 patients in the analysis. Seventy-two patients had a history of hypothyroidism, and of these, 63% received thyroid hormone replacement. Patients receiving replacement had significantly lower NIHSS at presentation (median 4 [IQR 1, 11]) compared with either the control group (median 8 [IQR 3, 16]) or hypothyroid patients without replacement (median 9 [IQR 3.8, 15.5]; P=.004). There was no difference in in-hospital and 3-month mortality or functional outcomes at 3 and 12 months among the groups.
  
  
  CONCLUSIONS
  This study suggests that the history of hypothyroidism does not affect clinical severity or outcome after ICH.
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut. Electronic address: alexandra.czap@gmail.com.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Czap
authors.forename: John P
authors.initials: JP
authors.lastname: Shoup
authors.forename: Jonathan
authors.initials: J
authors.lastname: Winkler
authors.forename: Ilene
authors.initials: I
authors.lastname: Staff
authors.forename: Gil
authors.initials: G
authors.lastname: Fortunato
authors.forename: Carl
authors.initials: C
authors.lastname: Malchoff
authors.forename: Louise D
authors.initials: LD
authors.lastname: McCullough
authors.forename: Lauren H
authors.initials: LH
authors.lastname: Sansing
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D004185:Disability Evaluation; D005260:Female; D015600:Glasgow Coma Scale; D020249:Hormone Replacement Therapy; D017052:Hospital Mortality; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010351:Patient Discharge; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013963:Thyroid Hormones / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D013963:Thyroid Hormones
keywords: Intracerebral hemorrhage; hypothyroidism; outcomes; retrospective studies; severity