Pattern and location of intracerebral hemorrhage in Enugu, South‑East Nigeria: A review of 139 cases

Abstract

Introduction: The incidence rates and location of nontraumatic intracerebral hemorrhage (ICH) have been shown to vary between population and races. Knowledge of ICH patterns may give some insight into the etiology of ICH and help reduce its burden particularly among Africans where health infrastructure is poorly developed. We present a retrospective review of ICH using a modern neuroimaging technique.

Objectives: To determine the pattern and location of ICH among patients presenting in a tertiary hospital in Enugu.

Methods: All the medical and computer tomography records of patients with a clinical diagnosis of hemorrhagic stroke with the location of hemorrhage clearly specified and complete patients’ data were reviewed. The study duration was 11 years (January 2003 to December 2013). Relevant data were obtained, and statistical analysis was done using SPSS version 19 (IBM Corporation, New York, USA).

Results: A total of 139 (17.4%) out of 799 scans done over the period under review were analyzed. The frequency of lobar and deep cerebral hemorrhages (LH and DCHs) was 46.8% and 53.2%, respectively. The most common types of hemorrhage in men and women were deep cerebral (52.2% and 55.3%, respectively). Five percent (7/139) of all hemorrhages occurred in the cerebellum. Age distribution of the location of ICH shows that LHs peaked at 16 39 years while DCHs peaked at 40–49 years. There was not statistically significant difference between mean ages of occurrence of LH and hemorrhages of other locations.

Conclusion: Frequency of LH and DCH varied with age as LH peaked before the age of 40 while deep cerebral at 40–49 years. The age distribution of different types of ICH may suggest a higher role of other factors apart from hypertension. Further studies are required to establish the risk factors of LH and DCHs in our environment.

Keywords: Deep cerebral hemorrhage, intracerebral hemorrhage, lobar hemorrhage, Nigeria