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Updated: May 30, 2026
09:01
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Prognosis in intracerebral hemorrhage
Kenneth M Crandall1, Natalia S Rost, Kevin N Sheth
1Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Reviews in Neurological Diseases
|July 20, 2011
Summary
Intracerebral hemorrhage (ICH) is a severe stroke with no proven therapies. Prognostic scales help predict outcomes, but care withdrawal in early stages may impact results.
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Background:
- Intracerebral hemorrhage (ICH) presents a high mortality rate and limited treatment options.
- Current management is largely supportive, often leading to difficult end-of-life decisions for families.
- Clinical grading scales aim to predict prognosis and guide patient care strategies.
Purpose of the Study:
- To review the development and application of prognostic scales in intracerebral hemorrhage.
- To examine the impact of care withdrawal on the interpretation of prognostic scales.
- To highlight the importance of timely interventions and revised guidelines for care decisions.
Main Methods:
- Literature review of prognostic scales for intracerebral hemorrhage.
- Analysis of studies including patients with withdrawn care in scale development.
- Examination of guidelines regarding the timing of care withdrawal decisions.
Main Results:
- The ICH scale was an early validated tool for predicting 30-day mortality.
- Subsequent scales predict mortality and functional outcomes.
- Patients with withdrawn care are often excluded from analyses, potentially skewing results.
- Care withdrawal frequently occurs within 48 hours, potentially before early interventions could show benefit.
Conclusions:
- Prognostic scales aid in predicting outcomes for intracerebral hemorrhage patients.
- The inclusion of withdrawn care in analyses may affect scale accuracy.
- Current guidelines recommend delaying care withdrawal decisions beyond 24 hours.
- Accurate interpretation of prognostic scales can support informed care decisions.
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