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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
[Etiologies and risk factors for young people with intracerebral hemorrhage]
Wenwen Li1, Qiying Sun1, Xian Duan1
1Department of Geriatrics Neurology, Xiangya Hospital, Central South University, Changsha 410008, China.
Insights
Intracerebral hemorrhage in young people is increasingly common with age and affects men more. Hypertension is the primary cause, followed by congenital cerebrovascular malformations, with hypertension, smoking, and alcohol as key controllable risk factors.
Area of Science:
- Neurology
- Vascular Neurology
- Epidemiology
Background:
- Intracerebral hemorrhage (ICH) in young individuals presents unique etiological challenges.
- Understanding age-specific risk factors and causes is crucial for prevention and management.
Purpose of the Study:
- To investigate the etiologies and risk factors of intracerebral hemorrhage in young patients.
- To analyze differences in these factors across distinct age groups (20-29, 30-39, 40-45).
Main Methods:
- A cohort of 401 young patients with intracerebral hemorrhage was analyzed.
- Patients were stratified into three age groups for comparative analysis of etiologies and risk factors.
Main Results:
- Hypertension was the leading cause (56.36%), followed by congenital cerebrovascular malformations (10.22%).
- The incidence of hypertension-related hemorrhage and overall hypertension risk increased significantly with age.
- Congenital vascular malformations were more prevalent in the youngest age group (20-29).
- Smoking and alcohol consumption were significant risk factors but did not show age-related differences.
Conclusions:
- Intracerebral hemorrhage incidence rises with age in young populations, with a higher prevalence in males.
- Hypertension is the primary driver, with congenital cerebrovascular malformations being a significant secondary cause, particularly in younger individuals.
- Hypertension, smoking, and alcohol consumption represent major modifiable risk factors for ICH in young adults.
Objective:
To determine the etiologies and risk factors of intracerebral hemorrhage in young people. Methods: A total of 401 young patients with intracerebral hemorrhage were enrolled, and they were assigned into a 20-29 , a 30-39, and a 40-45 age group. The differences of various etiologies and risk factors among the three groups were analyzed. Results: There were 273 men and 128 women in the 401 young patients. The etiologies of 294 patients (73.32%) were identified while 107 patients (26.68%) were unknown. Among those with identified etiology, 226 patients (56.36%) suffered from hypertension, 41 patients (10.22%) congenital cerebrovascular malformation (including 25 patients with cerebral arteriovenous malformation, 8 intracranial cavernous hemangioma, and 8 intracranial aneurysm), and 27 other etiologies (including 9 patients with moyamoya disease, 6 cerebral venous sinus thrombosis, 4 drug abuse, 3 hemorrhagic brain tumor, 2 intracranial infection, 1 systemic lupus erythematosus, 1 drug-induced, and 1 eclampsia). Risk factors included hypertension (237 cases, 59.10%), smoking (123 cases, 30.67%), alcohol consumption (74 cases, 18.45%), and others (19 cases, 4.74%; including 8 cases of pregnancy or in the puerperium, 8 family history of intracerebral hemorrhage, and 3 taking anti-platelet aggregation/anticoagulation agents). The rate of hypertension induced hemorrhage significantly increased with age (P<0.01); the rate of vascular malformations in 20-29 age group was obviously higher than other groups (P<0.01); the rate of unknown cause in the 40-45 age group was significantly lower than other groups (P<0.01) and the rate of other etiologies showed no significant difference in the 3 groups. The rate of hypertension was significantly elevated with the age (P<0.01), while smoking, alcohol consumption, and other risk factors showed no significant difference in the 3 groups. Conclusion: The rate of intracerebral hemorrhage in young people increases with the increasing of age and hemorrhage affects men more than women; hypertension may be the main cause and congenital cerebrovascular malformation is the second cause, which may be more common in younger patients. Hypertension, smoking, and alcohol consumption may be the major controllable risk factors in intracerebral hemorrhage in young people.
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