Prediction of Clinical Outcome in Acute Hemorrhagic Stroke from a Single CT Scan on Admission

BACKGROUND: From a single CT scan in primary intracerebral hemorrhage (ICH), clinical outcome can be assessed on admission by using the CT scan parameters. AIMS: The study aims to find out how hematoma volume, location of stroke, midline shift, intraventricular extension of bleed and ventricle compression influence the clinical outcome in patients with acute ICH. MATERIALS AND METHODS: Non-contrast CT scan was done on admission in hospital for every patient with acute hemorrhagic stroke and was analyzed accordingly. Clinical assessments were done in National Institute of Health Stroke Scale (NIHSS). Chi-square test and multiple logistic regression analysis were used for statistical analysis. RESULTS: Mean hematoma volume associated with death before 30 days is 33.16 cm(3) (P < 0.0001), with survived after 30 days is 15.45 cm(3) (P < 0.0001), with NIHSS score ≥16 is 29.03 cm(3) (P < 0.0001) and with NIHSS score <16 is 13.69 cm(3) (P < 0.0001). Independent poor prognostic factors were hematoma volume > 30 cm(3) (OR = 27.857), brain stem hemorrhage (OR = 6.000), intraventricular extension of bleed from other location (OR = 7.846), presence of ventricular compression alone (OR = 2.700) and in combination with midline shift of ≥ 5 mm (OR = 2.124). CONCLUSIONS: From a single CT scan during hospital admission, mortality and morbidity in next 30 days can be predicted. A hematoma volume >30 cm(3), brain stem hematoma, intraventricular extension of bleed and ventricular compression along and with midline shift are associated with early mortality in ICH.