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Intracerebral Hemorrhage Prognosis

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Intracerebral Hemorrhage Therapeutics

Abstract

Predicting outcome and communicating prognosis to patients and families are a core aspect of caring for patients with intracerebral hemorrhage. In the absence of a definitive treatment, the mortality rate from ICH remains high, with conflicting evidence regarding whether it is decreasing over time. The majority of ICH patients die following withdrawal of life-sustaining treatment, suggesting that provider and patient perceptions about prognosis can profoundly affect survival and neurological outcome. This phenomenon also creates the potential for a “self-fulfilling prophecy,” whereby perceived poor prognosis results in withdrawal of care and may then influence future predictions and prognostic models. Several clinical and patient factors – such as age, hematoma volume, and GCS – have consistently been found to predict prognosis. Additionally, numerous models have been developed to predict survival and neurological outcome in ICH. The ICH score remains the most widely utilized of these scores. While prognostic scores are extremely valuable for standardizing communication between providers and risk-stratifying individuals for research purposes, caution should be exercised in extending population-based outcome predictors to individual patients. Overall, accurate prognostication remains a challenging task for clinicians that is best facilitated by integrating information from prognostic models with individual clinical judgment.

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Authors and Affiliations

  1. Departments of Neurosurgery and Neurology, University of Michigan, Ann Arbor, MI, USA

    Craig A. Williamson & Venkatakrishna Rajajee

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  1. Craig A. Williamson
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  2. Venkatakrishna Rajajee
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Correspondence to Craig A. Williamson .

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Editors and Affiliations

  1. University of California, San Francisco Medical Center, San Francisco, CA, USA

    Bruce Ovbiagele

  2. University of Minnesota, Minneapolis, MN, USA

    Adnan I. Qureshi

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Williamson, C.A., Rajajee, V. (2018). Intracerebral Hemorrhage Prognosis. In: Ovbiagele, B., Qureshi, A. (eds) Intracerebral Hemorrhage Therapeutics. Springer, Cham. https://doi.org/10.1007/978-3-319-77063-5_7

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  • DOI: https://doi.org/10.1007/978-3-319-77063-5_7

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