Spontaneous intracerebral hemorrhage in young adults

Few studies have addressed intracerebral hemorrhage (ICH) in younger adults. We studied spontaneous ICH in adults ≤45 years of age. We retrospectively reviewed patients hospitalized with ICH between 2000 and 2001 to investigate incidence, etiology, risk factors, bleeding sites, management, and prognosis. Patients (224 men, 72 women; 37.0 ± 7.7 years) had a mortality rate of 24%. The most common risk factor for mortality was hypertension (HTN) (48.7%). Bleeding was most common in the ganglion (49.0%). Multiple hemorrhages (83.3%) caused the highest mortality, with the most common cause of mortality being HTN (46.6%). Coagulopathy (62.5%) caused the highest mortality based on etiologic classification. Recurrent HTN-induced hemorrhage rate was 3.6%. In Taiwanese adults ≤45 years of age, ICHs mainly involve the ganglion and result from HTN. Rates of HTN-induced hemorrhage are higher in Taiwan (46.6%) than elsewhere. Differences between races or countries should be investigated further.