Abstract
The fate of patients with intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) is very diverse, and clinical courses during hospitalization vary as well. Therefore, it is important to predict the prognosis for patients with hemorrhagic stroke and to provide individualized care accordingly. However, there is an abundance of factors known as prognostic factors that impact the outcome of hemorrhagic stroke. Simply listing these factors would not be helpful in practice. In this chapter, we will categorize these factors in an easy-to-understand way according to pathophysiology, as follows: first, in ICH, factors will be categorized into three groups—(1) “attack factors,” which may worsen the status of the brain following a hemorrhage; (2) “protective factors,” related to the resistance of the brain against hemorrhage; and (3) “systemic and neurological states,” related to systemic and neurological conditions affecting the overall prognosis following ICH. With respect to SAH, neurological and radiological findings at the time of presentation strongly reflect the disease prognosis. Thus, we will first describe several clinical and radiological grading systems and then describe the prognostic factors associated with complications following SAH. Our hope is that this chapter will guide you to a better understanding of the prognostic factors in hemorrhagic stroke.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Mayer SA, Sacco RL, Shi T, et al. Neurologic deterioration in noncomatose patients with supratentorial intracerebral hemorrhage. Neurology. 1994;44:1379–84.
Weimar C, Weber C, Wagner M, et al. Management patterns and health care use after intracerebral hemorrhage. A cost-of-illness study from a societal perspective in Germany. Cerebrovasc Dis. 2003;15:29–36.
Rost NS, Smith EE, Chang Y, et al. Prediction of functional outcome in patients with primary intracerebral hemorrhage: the FUNC score. Stroke. 2008;39:2304–9.
Zia E, Engstrom G, Svensson PJ, et al. Three-year survival and stroke recurrence rates in patients with primary intracerebral hemorrhage. Stroke. 2009;40:3567–73.
Davis SM, Broderick J, Hennerici M, et al. Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage. Neurology. 2006;66:1175–81.
Schlunk F, Greenberg SM. The pathophysiology of intracerebral hemorrhage formation and expansion. Transl Stroke Res. 2015;6:257–63.
Demchuk AM, Dowlatshahi D, Rodriguez-Luna D, et al. Prediction of haematoma growth and outcome in patients with intracerebral haemorrhage using the CT-angiography spot sign (PREDICT): a prospective observational study. Lancet Neurol. 2012;11:307–14.
Hemphill JC 3rd, Greenberg SM, Anderson CS, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46:2032–60.
Boulouis G, Morotti A, Brouwers HB, et al. Association between hypodensities detected by computed tomography and hematoma expansion in patients with intracerebral hemorrhage. JAMA Neurol. 2016;73:961–8.
Li Q, Zhang G, Xiong X, et al. Black hole sign: novel imaging marker that predicts hematoma growth in patients with intracerebral hemorrhage. Stroke. 2016;47:1777–81.
Mayer SA, Brun NC, Begtrup K, et al. Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med. 2008;358:2127–37.
Murthy SB, Moradiya Y, Dawson J, et al. Perihematomal edema and functional outcomes in intracerebral hemorrhage: influence of hematoma volume and location. Stroke. 2015;46:3088–92.
Balami JS, Buchan AM. Complications of intracerebral haemorrhage. Lancet Neurol. 2012;11:101–18.
Lee SH, Kim BJ, Ryu WS, et al. White matter lesions and poor outcome after intracerebral hemorrhage: a nationwide cohort study. Neurology. 2010;74:1502–10.
Lee SH, Bae HJ, Kwon SJ, et al. Cerebral microbleeds are regionally associated with intracerebral hemorrhage. Neurology. 2004;62:72–6.
Soo YO, Yang SR, Lam WW, et al. Risk vs benefit of anti-thrombotic therapy in ischaemic stroke patients with cerebral microbleeds. J Neurol. 2008;255:1679–86.
Greenberg SM, Eng JA, Ning M, et al. Hemorrhage burden predicts recurrent intracerebral hemorrhage after lobar hemorrhage. Stroke. 2004;35:1415–20.
Wong KS, Chan YL, Liu JY, et al. Asymptomatic microbleeds as a risk factor for aspirin-associated intracerebral hemorrhages. Neurology. 2003;60:511–3.
Lee SH, Ryu WS, Roh JK. Cerebral microbleeds are a risk factor for warfarin-related intracerebral hemorrhage. Neurology. 2009;72:171–6.
Lee SH, Kim BJ, Roh JK. Silent microbleeds are associated with volume of primary intracerebral hemorrhage. Neurology. 2006;66:430–2.
Celikbilek A, Goksel BK, Zararsiz G, et al. Spontaneous intra-cerebral hemorrhage: a retrospective study of risk factors and outcome in a Turkish population. J Neurosci Rural Pract. 2013;4:271–7.
Camacho E, Lopresti MA, Bruce S, et al. The role of age in intracerebral hemorrhages. J Clin Neurosci. 2015;22:1867–70.
Devaraj S, Dasu MR, Jialal I. Diabetes is a proinflammatory state: a translational perspective. Expert Rev Endocrinol Metab. 2010;5:19–28.
Lee SH, Kim BJ, Bae HJ, et al. Effects of glucose level on early and long-term mortality after intracerebral haemorrhage: the acute brain bleeding analysis study. Diabetologia. 2010;53:429–34.
Deogaonkar A, De Georgia M, Bae C, et al. Fever is associated with third ventricular shift after intracerebral hemorrhage: pathophysiologic implications. Neurol India. 2005;53:202–6.
Schwarz S, Hafner K, Aschoff A, et al. Incidence and prognostic significance of fever following intracerebral hemorrhage. Neurology. 2000;54:354–61.
Rossi S, Zanier ER, Mauri I, et al. Brain temperature, body core temperature, and intracranial pressure in acute cerebral damage. J Neurol Neurosurg Psychiatry. 2001;71:448–54.
Broessner G, Beer R, Lackner P, et al. Prophylactic, endovascularly based, long-term normothermia in ICU patients with severe cerebrovascular disease: bicenter prospective, randomized trial. Stroke. 2009;40:e657–65.
Saloheimo P, Ahonen M, Juvela S, et al. Regular aspirin-use preceding the onset of primary intracerebral hemorrhage is an independent predictor for death. Stroke. 2006;37:129–33.
Dowlatshahi D, Butcher KS, Asdaghi N, et al. Poor prognosis in warfarin-associated intracranial hemorrhage despite anticoagulation reversal. Stroke. 2012;43:1812–7.
Al-Khindi T, Macdonald RL, Schweizer TA. Cognitive and functional outcome after aneurysmal subarachnoid hemorrhage. Stroke. 2010;41:e519–36.
Frontera JA, Claassen J, Schmidt JM, et al. Prediction of symptomatic vasospasm after subarachnoid hemorrhage: the modified fisher scale. Neurosurgery. 2006;59:21–7.
Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968;28:14–20.
Teasdale GM, Drake CG, Hunt W, et al. A universal subarachnoid hemorrhage scale: report of a committee of the World Federation of Neurosurgical Societies. J Neurol Neurosurg Psychiatry. 1988;51:1457.
Degen LA, Dorhout Mees SM, Algra A, et al. Interobserver variability of grading scales for aneurysmal subarachnoid hemorrhage. Stroke. 2011;42:1546–9.
Jaja BN, Cusimano MD, Etminan N, et al. Clinical prediction models for aneurysmal subarachnoid hemorrhage: a systematic review. Neurocrit Care. 2013;18:143–53.
Jaja BNR, Saposnik G, Lingsma HF, et al. Development and validation of outcome prediction models for aneurysmal subarachnoid haemorrhage: the SAHIT multinational cohort study. BMJ. 2018;360:j5745.
Mocco J, Ransom ER, Komotar RJ, et al. Preoperative prediction of long-term outcome in poor-grade aneurysmal subarachnoid hemorrhage. Neurosurgery. 2006;59:529–38.
Rosen DS, Macdonald RL. Grading of subarachnoid hemorrhage: modification of the World Federation of Neurosurgical Societies scale on the basis of data for a large series of patients. Neurosurgery. 2004;54:566–75.
Claassen J, Bernardini GL, Kreiter K, et al. Effect of cisternal and ventricular blood on risk of delayed cerebral ischemia after subarachnoid hemorrhage: the Fisher scale revisited. Stroke. 2001;32:2012–20.
Howington JU, Kutz SC, Wilding GE, et al. Cocaine use as a predictor of outcome in aneurysmal subarachnoid hemorrhage. J Neurosurg. 2003;99:271–5.
Lasner TM, Weil RJ, Riina HA, et al. Cigarette smoking-induced increase in the risk of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage. J Neurosurg. 1997;87:381–4.
Ohman J, Servo A, Heiskanen O. Risks factors for cerebral infarction in good-grade patients after aneurysmal subarachnoid hemorrhage and surgery: a prospective study. J Neurosurg. 1991;74:14–20.
Harrod CG, Bendok BR, Batjer HH. Prediction of cerebral vasospasm in patients presenting with aneurysmal subarachnoid hemorrhage: a review. Neurosurgery. 2005;56:633–54.
De Rooij NK, Rinkel GJ, Dankbaar JW, et al. Delayed cerebral ischemia after subarachnoid hemorrhage: a systematic review of clinical, laboratory, and radiological predictors. Stroke. 2013;44:43–54.
Larsen CC, Astrup J. Rebleeding after aneurysmal subarachnoid hemorrhage: a literature review. World Neurosurg. 2013;79:307–12.
Tang C, Zhang TS, Zhou LF. Risk factors for rebleeding of aneurysmal subarachnoid hemorrhage: a meta-analysis. PLoS One. 2014;9:e99536.
Van Donkelaar CE, Bakker NA, Veeger NJ, et al. Predictive factors for rebleeding after aneurysmal subarachnoid hemorrhage: rebleeding aneurysmal subarachnoid hemorrhage study. Stroke. 2015;46:2100–6.
Chen S, Luo J, Reis C, et al. Hydrocephalus after subarachnoid hemorrhage: pathophysiology, diagnosis, and treatment. Biomed Res Int. 2017;2017:8584753.
Wilson CD, Safavi-Abbasi S, Sun H, et al. Meta-analysis and systematic review of risk factors for shunt dependency after aneurysmal subarachnoid hemorrhage. J Neurosurg. 2017;126:586–95.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer Science+Business Media Singapore
About this chapter
Cite this chapter
Kang, DW., Lee, SH. (2018). Prediction of Prognosis After Hemorrhagic Stroke. In: Lee, SH. (eds) Stroke Revisited: Hemorrhagic Stroke. Stroke Revisited. Springer, Singapore. https://doi.org/10.1007/978-981-10-1427-7_15
Download citation
DOI: https://doi.org/10.1007/978-981-10-1427-7_15
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-10-1426-0
Online ISBN: 978-981-10-1427-7
eBook Packages: MedicineMedicine (R0)