Serum homocysteine in intracerebral hemorrhage: A savior or a destroyer?

Objectives: Intracerebral hemorrhage (ICH) is more common in the Indian subcontinent compared to the Western world and associated with significant morbidity and mortality. Hence, all possible modifiable factors should be searched and steps taken so that a single opportunity is not missed in preventing such a catastrophe. The aim of the study is to find out whether homocysteine and Vitamin B12 are related to ICH. Materials and Methods: We included acute ICH patients of 18 years and above who came to our institute and got admitted in 5 months (September 2021–January 2022). Our team noted the demographics, National Institutes of Health Stroke Scale (at admission and discharge) and other clinical parameters. Volume and site of the intracerebral hematoma (from the initial computed tomography [CT] scan of the brain) were noted. The outcome and prognostic markers like Modified Rankin Scale (mRS) at discharge, MRS at 3 months (also MRS at admission) and ICH score were calculated. The blood parameters, including serum homocysteine and Vitamin B12 level, were noted post admission in hospital. Results: We found out of 44 ICH patients; ten patients had hyperhomocysteinemia (HHcy): 22.72%. We detected significant correlation between HHCy with ICH score (inverse relationship) and dyslipidemia (direct relationship). Conclusion: We found an inverse correlation between serum homocysteine level and ICH score, which shows a short-term (1 month) prognosis. This might hint that homocysteine might have a protective role to play in ICH. However, we probably need larger study population to find a correlation strong enough so that we can make a stronger conclusion.