Approximately 1 of 10 strokes is a spontaneous intracerebral hemorrhage (ICH), and approximately 1 in 5 stroke deaths is due to ICH. Benefit has not been established for any specific medical or surgical therapy. The University of Cincinnati Stroke Team has developed an 11-hospital network for investigation of ischemic and hemorrhagic stroke. 51 patients have been investigated as of 1/91 (of 52 promised by 6/1/91). Each of the patients has been evaluated neurologically at baseline (0-3 hours from symptom onset), 1 hour from baseline, and 20 hours from ICH onset. The patients have had computed tomographic brain scans (CT) at those same times. Deep hemorrhages (basal ganglia, thalamus) were more likely to grown than lobar hemorrhages. Deterioration in the Glasgow Coma Scale and the NIH Stroke Scale was associated with hemorrhage growth. We will evaluate an additional 75 patients with spontaneous ICH to: 1) Determine more precisely the early radiographic predictors of ICH growth (e.g. thalamic location vs. putaminal location), 2) Confirm the preliminary findings that clinical characteristics which can be defined acutely (e.g. admission blood pressure) do not predict hemorrhage growth, 3) Establish quantitatively the time course of cerebral edema over the initial 72 hours, 4) Confirm that hemorrhage growth and edema growth predict subsequent morbidity and mortality, and 5) Measure the radiographic effects of surgical removal of ICH and analyze the relationship of those changes to morbidity and mortality.
