EARLY HEMORRHAGE GROWTH IN PATIENTS WITH INTRACEREBRAL HEMORRHAGE

Background and Purpose The goal of the present study was to prospectiv ely determine how frequently early growth of intracerebral hemorrhage occurs and whether this early growth is related to early neurological deterioration. Methods We performed a prospective observational study of patients with intracerebral hemorrhage within 3 hours of onset. Pat ients had a neurological evaluation and CT scan performed at baseline, 1 hour after baseline, and 20 hours after baseline. Results Substanti al growth in the volume of parenchymal hemorrhage occurred in 26% of t he 103 study patients between the baseline and 1-hour CT scans. An add itional 12% of patients had substantial growth between the 1- and 20-h our CT scans. Hemorrhage growth between the baseline and 1-hour CT sca ns was significantly associated with clinical deterioration, as measur ed by the change between the baseline and 1-hour Glasgow Coma Scale an d National Institutes of Health Stroke Scale scores. No baseline clini cal or CT prediction of hemorrhage growth was identified. Conclusions Substantial early hemorrhage growth in patients with intracerebral hem orrhage is common and is associated with neurological deterioration. R andomized treatment trials are needed to determine whether this early natural history of ongoing bleeding and frequent neurological deterior ation can be improved.