Section 1 - Epidemiology

Summary

This chapter reviews the epidemiology of non-traumatic intracerebral hemorrhage (ICH) in light of modern neuroimaging and discusses the incidence, etiology, clinical presentation, and natural history of this condition. Risk for ICH appears to be marginally greater in men than in women, driven by an excess of deep hemorrhages. Incidence rates increase dramatically among persons older than 60. Hypertension is the most important and prevalent modifiable risk factor for ICH. The clinical features used to define ICH are presentation with a gradual progression (over minutes or days) or sudden onset of focal neurological deficit, usually accompanied by signs of increased intracranial pressure such as vomiting or diminished consciousness. A variety of reports have examined clinical and radiographic factors associated with prognosis after ICH. Primary intraventricular hemorrhage (IVH) is rare among adults, comprising 2-3% of ICH admissions. Signs and symptoms of IVH frequently include headache, vomiting, and altered level of consciousness.