Background: Non-traumatic intracerebral haemorrhage (ICH) is a neurological emergency, because it carries a burden of mortality and long-term disability worldwide. Aim: To compare urban and rural differences in hospitalisation due to ICH. Materials and Methods: An analytical study was conducted among ICH cases admitted to the Third State Central Hospital between 2022 and 2024, and statistical analysis was performed using SPSS 27.0. Result: The study included 373 cases of acute ICH diagnosed by computed tomography between 2022 and 2024 at the Third State Central Hospital, of which n=313 were from Ulaanbaatar city, and n=60 were transported from the rural area. Compared to the urban group, the rural group had fewer males, but a history of arterial hypertension prevailed (98.3% vs 90.1%, p=0.041), and lower blood pressure at the time of hospitalisation (systolic pressure 159.7±34.7 mm Hg vs 179.0±32.9 mm Hg, p<0.001; diastolic pressure 99.7±21.4 mm Hg vs 106.5±21.8 mm Hg, p=0.026). Cases in the rural group had a longer hospital stay from the onset of clinical symptoms than those in the urban group (12.1±17.9 hours vs 4.2±4.3 hours, p=0.001). Multivariate regression analysis showed that lower hematoma volume (adjusted odds ratio [aOR] 0.92, p=0.047) and lower NIHSS score at hospital admission (aOR 0.67, p<0.001) were associated with better outcomes. However, multivariate regression analysis showed that hospital admission NIHSS score was the only risk factor directly associated with mortality after 3 months (aOR 1.14, p=0.005). Conclusion Our study found that indicators for patients transported from rural areas with IHC were no different from those for patients in urban areas. On the contrary, mortality was independent of length of hospital stay and residency.

Background: Non-traumatic intracerebral hemorrhage (ICH) represents the most devastating subtype of stroke, charac terized by spontaneous bleeding into the brain parenchyma. This neurological emergency carries a burden of mortality and long-term disability worldwide. Timely identification causal pathways is priority objective for adequate primary and secondary prevention of ICH. Risk factors may differ between ICH subtypes, and stratified approaches to management may be appropriate. Aim: This study is to identify cause and risk factors of ICH. Materials and Methods: A single centre descriptive study was carried out in Stroke Center of the State Third Central Hospital, Mongolia, including 718 consecutive acute patients with ICH during October 2022 to September 2024. Patients were classified using SMASH-U, an etiological based classification system. Results: Out of a total of 718 cases diagnosed with ICH, hypertension caused 75.3%, amyloid angiopathy 12%, undetermined 7%, structural lesions 2.92%, systemic disease 2.37%, medication 0.48% in 718 ICH patients. The mean age of the cases was 57.5 жил, and was the most common in men of the 50-59 age group (p<0.001). The main risk factor in hypertension and amyloid angiopathy groups was arterial hypertension (93.7%), in undetermined group alcohol consumption (48%), in structural group AVM and other vascular causes (23.8%), in systemic group chronic kidney insufficiency (29.4%), in medication group atrial fibrillation (100%), respectively. Conclusion 1. ICH was mostly caused by hypertension, amyloid angiopathy, systemic disease. 2. Arterial hypertension, heart disease, atrial fibrillation, previous stroke, oral anticoagulants, smoking, alcohol consumption, obesity/BMI≥25, liver cirrhosis, chronic kidney insufficiency, AVM and other structural anomalies were the most common risk factors.

Purpose: Brain metastases from renal cell carcinoma (RCC) have been successfully treated with stereotactic radiosurgery (SRS). Metastases to extra-cranial sites may be treated with similar success using stereotactic body radiation therapy (SBRT), where image-guidance allows for the delivery of precise high-dose radiation in a few fractions. This paper reports the authors’ initial experience with image-guided SBRT in treating primary and metastatic RCC. Materials and methods: The image-guided Brainlab Novalis stereotactic system was used. Fourteen patients with 23 extra-cranial metastatic RCC lesions (orbits, head and neck, lung, mediastinum, sternum, clavicle, scapula, humerus, rib, spine and abdominal wall) and two patients with biopsy-proven primary RCC (not surgical candidates) were treated with SBRT (24-40 Gy in 3-6 fractions over 1-2 weeks). All patients were immobilised in body cast or head and neck mask. Image-guidance was used for all fractions. PET/CT images were fused with simulation CT images to assist in target delineation and dose determination. SMART (simultaneous modulated accelerated radiation therapy) boost approach was adopted. 4D-CT was utilised to assess tumour/organ motion and assist in determining planning target volume margins. Results: Median follow-up was nine months. Thirteen patients (93%) who received SBRT to extra-cranial metastases achieved symptomatic relief. Two patients had local progression, yielding a local control rate of 87%. In the two patients with primary RCC, tumour size remained unchanged but their pain improved, and their renal function was unchanged post SBRT. There were no significant treatment-related side effects. Conclusion: Image-guided SBRT provides excellent symptom palliation and local control without any significant toxicity. SBRT may represent a novel, non-invasive, nephron-sparing option for the treatment of primary RCC as well as extra-cranial metastatic RCC.