1.Etiology and risk factors of intracerebral hemorrhage
Dembereldorj S ; Bayarmaa P ; Jargalsaikhan S ; Tovuudorj A ; Shin-Joe Yeh ; Lkhamtsoo N
Mongolian Journal of Health Sciences 2025;88(4):178-182
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.
2.Prediction of clinical outcome based on hematoma location and volume in intracerebral hemorrhage
Dembereldorj S ; ; Tovuudorj A ; Shin-Joe Yeh ; Natsagdorj L
Mongolian Journal of Health Sciences 2025;89(5):85-89
Background:
Non-traumatic intracerebral hemorrhage (ICH), an neurological emergency carries a burden of mortality
and long-term disability worldwide. Blood pressure and level of consciousness at the admission, location and volume of
parenchymal hemorrhage, volume of intraventricular hemorrhage have been most consistently linked with poor outcome.
Aim:
To asssess a relationship between hematoma location, volume and clinical outcome in patients with acute ICH.
Materials and Methods:
An analytical study was carried out in Third State Central Hospital, between 2022 and 2024,
and statistical analysis was performed using SPSS 25.0 program.
Results:
Total of 385 cases diagnosed with acute ICH included in the study. The clinical outcomes differed significantly
according to ICH location and hematoma volume (р<0.001). Lobar ICH was associated with a significantly lower risk
of poor outcome (OR, 0.458 [95% CI, 0.21–0.99]), and highest risk for poor outcome in intraventricular hemorrhage
(OR, 2.03 [95% CI, 1.07-3.85]). The risk of poor outcome at 3 months were the highest for brainstem (OR, 3.36 [95%
CI, 1.68-6.69]), intraventricular rupture (OR, 4.91 [95% CI, 3.16-7.63]), but lowest for infratentorial-located ICHs (OR,
0.42 [95% CI, 0.23-0.76]). All receiver operating characteristic models for location-specific vutoffs had good discriminant
values (area under the curve >0.8), except in predicting good outcome for cerebellum and thalamus (<10.2 ml, <6.7 ml
respectively).
Conclusion
The interaction between hematoma volume and location exerted a direct effect on ICH outcome.
Result Analysis
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