Spontaneous Intracerebral Hemorrhage: Epidemiology, Clinical Profile and Short-Term Outcome in a Tertiary Hospital in Sub-Saharan Africa

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. Su-barachnoid 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 Kap-lan 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, cere-bral 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 < 9 [OR (95% CI) = 3.538 (1.086-11.526), p = 0.036] and NIHSS 15-24 [OR (95% CI) = 7.498 (1.306-43.029), p = 0.024] were independent predictors of in-hospital mor-How to cite this paper: Doumbe, J., Ab-douramani, K., Gams, D.M., Ayeah, C.M., 142 World Journal of Neuroscience tality while mass effect [OR (95% CI) = 3.563 (1.217-10.432), p = 0.020] and hyperthermia [OR (95% CI) = 4.645 (1.341-16.085), p = 0.015] predict poor functional outcome. Six-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 6 th month.