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Intracerebral hemorrhage with hypothyroidism
Alexandra Czap1, John P Shoup, Jonathan Winkler
1University of Connecticut Health Center, Farmington, Connecticut.
Summary
Hypothyroidism history did not impact severity or outcomes in patients with primary intracerebral hemorrhage (ICH). Thyroid hormone replacement in hypothyroid patients was associated with lower initial stroke severity but did not alter long-term outcomes.
Area of Science:
- Neurology
- Endocrinology
- Stroke Medicine
Background:
- Hypothyroidism is linked to higher ischemic stroke risk but better outcomes post-stroke.
- The effect of hypothyroidism on primary intracerebral hemorrhage (ICH) outcomes is not well understood.
Purpose of the Study:
- To investigate the clinical presentation and outcomes of patients with spontaneous ICH and a history of hypothyroidism.
- To compare outcomes between hypothyroid patients receiving thyroid replacement and those without, as well as with non-hypothyroid patients.
Main Methods:
- Retrospective analysis of a prospective stroke center database.
- Inclusion of 563 patients: 491 without thyroid disease and 72 with hypothyroidism.
- Assessment of initial severity using Glasgow Coma Scale, ICH score, and NIHSS; outcomes measured by NIHSS and modified Barthel Index (mBI) changes, mortality, and discharge disposition at 3 and 12 months.
Main Results:
- Patients receiving thyroid hormone replacement had significantly lower NIHSS scores at presentation compared to controls or hypothyroid patients without replacement (P=.004).
- No significant differences were observed in in-hospital or 3-month mortality, or functional outcomes at 3 and 12 months across all groups.
Conclusions:
- A history of hypothyroidism does not appear to influence the clinical severity or patient outcomes following primary intracerebral hemorrhage.
- Thyroid hormone replacement may influence initial presentation severity but not long-term functional recovery or mortality in ICH patients.
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