A study of clinical profile, CT scan and risk profile in patients of intracerebral hemorrhage of geriatric versus non geriatric groups

Dr. V.N. Mishra; Dr. N.K. Tirkey; Dr. Spriha Parmar

Volume : V, Issue : X, October - 2015

A study of clinical profile, CT scan and risk profile in patients of intracerebral hemorrhage of geriatric versus non geriatric groups

Dr. V. N. Mishra, Dr. N. K. Tirkey, Dr. Spriha Parmar

Abstract :

Background : Age is a strong risk factor for Intra Cereal Hemorrhage (ICH). Several studies have shown high incidence of ICH in the elderly. Understanding the role of age in pattern of bleed and outcome can guide the management. Materials and Methods : 200 patients of ICH confirmed by CT Scan were studied between March 2012 to January 2014. They were sorted out into Group 1 consisting of 100 patients ≥ 60 years of age and Group 2 of 100 patients < 60 years of age. Patients with old stroke, fresh ICH due to other causes like head trauma, known bleeding tendency or coagulation disorder were excluded. Detailed history was taken using a structured questionnaire. General and systemic examination, CT scan head and required blood investigations were done. Chi–square test was used for statistical analysis. Results : Male : female ratio was 1.5:1 in group 1 and 3.5:1 in group 2. The most common presentation in group 1 was altered sensorium followed by motor deficit whereas in group 2 it was speech disturbance followed by altered sensorium ( P < 0.03). Glasgow Coma Scale in group 1 was less than 3 in 39% whereas in group 2 it was less than 3 in 9% only. Risk factors in decreasing order in group 1 were hypertension, hyperlipidemia, hyperglycemia, smoking and alcohol whereas in group 2 they were smoking, hyperlipidemia, hyperglycemia, hypertension and alcohol. Putamen was the most common site of bleed followed by thalamus in group 1 whereas in group 2 lobar bleed was common followed by thalamus. Intraventricular extension was more common in group 1 as compared to group 2 ( P=0.03). Group 1 had more tendency for a large volume bleed than group 2. Mortality was more in group 1 (67%) as compared to group 2 (52%) (P < 0.05). Modified Rankin scale was > 2 in majority of group 1 patients as compared to group 2 patients. Conclusions : ICH occurring in the geriatic population has several differences from that seen in the non geriatic population and these differences have a definite impact on the neurological outcome.