Evaluation of Clinical Presentation and Associated Comorbid Conditions in Patients with Spontaneous Intracerebral Hemorrhage in a Tertiary Care Hospital in Bangladesh

Abstract

Spontaneous intracerebral hemorrhage (ICH) has remained the least treatable form of stroke despite recent improvements in medical treatment. Treatment usually supportive and medical such as ventilatory support, blood pressure reduction, osmotherapy, fever control, seizure control and nutritional support and treatment of co morbidconditions. This study was carried out to see demographic variability, clinical presentation, causes and outcome of spontaneous intracerebral hemorrhage. Methods and materials: This was a cross sectional observational prospective in study on 50 spontaneous ICH patients admitted in Medicine department of Khulna Medical College Hospital from November 2020 to April, 2021. Result: The study showed that spontaneous ICH was most common in between 41-70 years. Their age frequency were 14 (28%) in 41-50 years, 15 (30%)in 51- 60 years, 12 (24%) in 61-70 years, 5 (10%) in 71- 80 years and 4 (8%) in more than 81 years age group. Among the patients, 64% (32) were male and 36% (18) were female. No of smoker male was 25(50%) and female was 1(2%) and no of nonsmoker male was 7(14%) and female was 17(34%). Headache was present in 56% (28) and absent in 44% (22) of patients. Vomiting was present in 54% (27) and was absent in 46% (23)of patients.Seizure was present in 16% (8) and was absent in 54% (42) of patients. Diabetes mellitus was present in 22% (11) of patients and absent in 78% (39) patients. Range of blood pressure –<140/90 in 24%(12), Systolic BP:140-159/Diastolic BP:90-99 (mm Hg) in 10%(5), Systolic BP:160-179/Diastolic BP:100-109 (mm Hg) in 22%(11),Systolic BP:180 or more/Diastolic BP:110 or more (mm Hg) in 44%(22) patients. Dyslipidemia was present in 30% (15) & absent in 70% (35) patients. Glasgow Coma Scale Score was 8 or less in 42% (21) and 9 or more in 58% (29) patients. Conclusion: Spontaneous ICH is common in Indian subcontinent. As death occur due to ICH itself, associated co morbidities or due to complications, management in stroke care unit, High dependency unit and Intensive care unit is required.