الفهرس 
Clinical and radiological predictors in intracerebral hemorrhage
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Abstract
Background: Spontaneous intracerebral hemorrhage (sICH) is the second most common form of stroke. It’s a major cause of morbidity and mortality. Several clinical and radiological parameters are related to poor outcome following an ICH.
Aim of work: To elucidate the clinical, laboratory, and radiological factors associated with poor outcome in patients with ICH.
Methodology: The present prospective study enrolled 70 patients with a documented diagnosis of sICH, based on comprehensive medical history, full neurological examination, standardized blood tests, and CT scan of the brain. Patients were assessed for early neurological deterioration (END) during the hospital stay (up to seven days from admission) using Glasgow coma scale (GSC), and the National Institutes of Health Stroke Scale (NIHSS), and within three months from stroke onset using modified Rankin scale (mRS). ICH score and Functional Outcome in Patients with Primary Intracerebral Hemorrhage (FUNC) Score were calculated for prognostication.
Results: 27.1% and 71.42% of patients had END and showed unfavorable outcome, respectively. Multivariate logistic regression analysis for prediction of poor outcome showed a significant regression regarding NIHSS, age, and serum urea while significant regression to aspiration was found for prediction of END.
Conclusion: Clinical indices, namely NIHSS >7 on admission and age >51 years, radiological characteristics, namely large hematoma size, leukoaraiosis, and mass effect detected on CT scan, as well as serum biomarkers; serum urea level >50 mg/dL, high neutrophil: lymphocyte ratio on admission, high ALT and AST, as well as low total, LDL, and HDL cholesterol levels, were significantly associated with poor outcome in patients with sICH. Amongst these, NIHSS >7 on admission, age >51 years, and urea level >50 mg/dL were independent predictors. Aspiration was found to be an independent predictor of END. Aggressive early management of ICH patients may improve outcomes