الفهرس 
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Abstract
According to our knowledge, this is the only study evaluating the correlation between ICH and low cholesterol in Egypt. We think, our study group reflects the population of upper Egypt because of the variability of the patients attending to our hospital from the various parts of upper Egypt.
The study included 80 patients diagnosed with primary ICH admitted to neurology department, Sohag university hospital and control group consisted of 50 consecutive healthy individuals without any diagnosed illness or treatment.
To conclude, in this study we found that low serum cholesterol, HDLC, LDLC, VLDLC levels were associated with an increased risk of intracerebral hemorrhage. Low serum cholesterol level were significantly associated with level of consciousness in ICH patients. This finding provides novel insights into the role of lipid metabolism in the etiology of intracerebral hemorrhage. Though the exact mechanism of the association remains unclear, cholesterol, LDLC, HDLC and VLDLC levels may aid in the identification of people at risk for intracerebral hemorrhage.
Therefore, although establishing an association between low serum cholesterol levels and intracranial haemorrhage, in this study we are still unable to comment about their causal relationship.
We concluded that clinicians should be aware of the risk of ICH in hypertensive and non hypertensive patients with very low cholesterol.
Further understanding of the relationship between serum cholesterol levels and different characteristics of patient with ICH must be evaluated and investigated in more and larger studies.
In addition, before treatment with lipid lowering agents, the hazards , risks and mortality rate of haemorrhagic and ischaemic stroke and that from coronary heart disease for each population and for all individual patients must be evaluated.
Further understanding of the relationship between serum lipids and primary ICH has implications for both prevention of ICH and the potential risks of lipid-lowering therapies.
We also cannot exclude the possibility of residual confounding by unmeasured determinants, for example environmental factors, diet or physical activity, or due to the fact that lipid levels and confounders were measured only once.
Recommedations
-We recommend that the impact of very low cholesterol on public health must be investigated with larger studies.
-We recommend that more studies should be done to determine the causal relationship between low serum cholesterol levels and ICH.
-We recommend that further understanding of the relationship between serum cholesterol levels and different characteristics of patient with ICH must be evaluated and investigated in more and larger studies.
-We recommend that another study to evaluate the prognosis and long term follow up for patients with ICH and relation to cholesterol levels.
-We recommend to emphasize that a proper assessment of the risks and benefits of a high cholesterol level will only be established by a cohort study.
-We recommend another long-term clinical trial required before any conclusion can be made that might influence our prescription of cholesterol-lowering drugs among patients at high risk of ICH.
-We recommend further detailed studies about other components of lipid profile and their contributions in primary ICH.
-We recommend other studies using time-varying analyses are needed to explore whether intraindividual fluctuations in lipid levels and confounders influence the results.