TITLE:
Spontaneous Intracerebral Hemorrhage: Epidemiology, Clinical Profile and Short-Term Outcome in a Tertiary Hospital in Sub-Saharan Africa
AUTHORS:
Jacques Doumbe, Khadidja Abdouramani, Daniel Massi Gams, Chia Mark Ayeah, Caroline Kenmegne, Yacouba Njankouo Mapoure
KEYWORDS:
Spontaneous Intracerebral Haemorrhage, Epidemiology, Prognosis, Africa
JOURNAL NAME:
World Journal of Neuroscience,
Vol.10 No.3,
August
14,
2020
ABSTRACT: Background: Data on spontaneous
intracerebral haemorrhagic (SICH) are scarce in Africa. Our objectives were to determine the prevalence of SICH, describe the clinical profile,
aetiology and evaluate the prognosis (fatality case, functional outcome) of
patients in a tertiary health care hospital in Cameroon. Methods: This
was a hospital-based retrospective cohort which included patients with SICH and followed up for 6 months after
stroke. Subarachnoid haemorrhage, cerebral venous thrombosis with bleeding or
bleeding related with ischemic or brain tumour were excluded. Predictive
factors were obtained using multiple logistic regression and survival by Kaplan
Meier method. Results: The prevalence of SICH was 37% with male
predominance (64.0%), a mean age of 55.6 ± 11.8 years. Deep coma was found in
30.3% on admission. The basal ganglion was the most frequent location of
haemorrhage (85.1%) while intraventricular blood effusion, mass effect,
cerebral oedema and herniation occurred in 31.4%, 25.7%, 8.8% and 5.0%
respectively. Hypertension (57.5%) was the most common aetiology. The mean
length of hospitalization was 9.0 ± 7.7 days and chest infection (30.7%) was
the most frequent complication. The cumulative case fatality rate after 24 hours
(day 1), during admission, month 1 and month 3 was 9.6%, 39.9%, 46.0%, 59.8%
respectively. On multivariate analysis, GCS -month survival was 37.8%. Conclusion: About one-third of stroke patient were
haemorrhagic. Hypertension is the leading CVRF and aetiology of spontaneous
ICH. About 1 over 2 patients with SICH would die within 3 months while 50% of
survivors would have a poor functional outcome at 6th month.