RISK-FACTORS FOR SPONTANEOUS INTRACEREBRAL HEMORRHAGE

Background and Purpose Spontaneous intracerebral hemorrhage has remain ed a serious disease despite recent improvements in medical treatment. This study was designed to identify modifiable risk factors for intra cerebral hemorrhage. Methods Health habits, previous diseases, and med ication of 156 consecutive patients with intracerebral hemorrhage aged 16 to 60 years (96 men and 60 women) were compared with those of 332 hospitalized control patients (192 men and 140 women) who did not diff er from case subjects in respect to age, day of onset of symptoms, or acuteness of disease onset. Results After adjustment for sex, age, hyp ertension, body mass index, smoking status, and alcohol consumption du ring the last week, patients who had consumed 1 to 40, 41 to 120, or > 120 g of alcohol within the 24 hours preceding the onset of illness ha d a relative risk (95% confidence interval) of hemorrhage of 0.3 (0.2 to 0.7), 4.6 (2.2 to 9.4), and 11.3 (3.0 to 42.8), respectively, compa red with those who had consumed 0 g. In addition, alcohol intake withi n 1 week before the onset of illness, excluding use within the last 24 hours, increased the risk of hemorrhage; adjusted risks were 2.0 (1.1 to 3.5) for 1 to 150 g, 4.3 (1.6 to 11.7) for 151 to 300 g, and 6.5 ( 2.4 to 17.7) for >300 g compared with 0 g. The adjusted risk of hypert ension for hemorrhage was 6.6 (3.9 to 11.3). Previous heavy alcohol co nsumption and current cigarette smoking were not independent risk fact ors for hemorrhage, but anticoagulant treatment was (P<.01). Erythrocy te mean corpuscular volume and gamma-glutamyl transferase values were also higher in patients with intracerebral hemorrhage than in control subjects. Conclusions Recent moderate and heavy alcohol intake as well as hypertension and likely also anticoagulant treatment seem to be in dependent risk factors for intracerebral hemorrhage.