Hemorrhagic stroke: experience of an internal medicine department

Stroke is the third leading cause of death in most industrialised countries, among adults aged 65 years or more. In Portugal, however, it is the leading cause of death. Intracerebral hemorrhages comprise approximately 10 to 15% of all strokes. This particular type of stroke is associated with a worse prognosis. There is little published data concerning stroke in the Portuguese population, especially on the hemorrhagic type of the disease. The aim of the present study was to improve our knowledge on the epidemiology of hemorrhagic strokes in our community. The hospital charts of 60 patients with intracerebral hemorrhage who were admitted to our wards during the years of 1997 and 1998 were retrospectively reviewed. There was a predominance of male patients aged over 65. In most cases (78.3%), no causal factor was identified (spontaneous or "primary" hemorrhagic stroke). Hypertension was present in 80% of cases and was the most common risk factor. The percentage of putaminal and thalamic hemorrhages (48.3%) was similar to the percentage of lobar hemorrhages (46.7%). This differs from other studies. The prognosis of our patients was fairly good, with 38% of all cases being independent at thirty days. The 30-day case fatality rate was 10%. As in other studies, advancing age, a low Glasgow Coma Scale score, a large hemorrhage size and the intraventricular extension of blood were associated with a worse outcome.