Khatri Ismail A, Almosa Moath, Alkahtani Abdulah, Alanazi Khaled, Masud Nazish
Department of Neurology, King Abdulaziz Medical City, MNGHA, Riyadh, Saudi Arabia.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Stroke Res Treat. 2025 Aug 21;2025:5550380. doi: 10.1155/srat/5550380. eCollection 2025.
Hypertension is the most common cause of intracerebral hemorrhage (ICH). The presentation, etiology, and outcome of ICH among young adults may vary compared to other age groups. The prior literature from our region has described a variety of etiologies with an inconsistent relationship to hypertension, which is the commonest cause of primary ICH in adults overall. We aimed to determine the demographic pattern, clinical presentation, underlying etiology, radiological characteristics, and outcome of ICH among young adults in our population. This was an IRB-approved chart review that included patients from January 2016 to December 2020. Descriptive young adults were defined as people between 15 and 45 years and arbitrarily divided into threee further age groups. A variety of demographic, clinical, and radiological features were compared among the subgroups and presented as descriptive and comparative analyses. A total of 120 patients were included; 110 (91.7%) were males. The mean age was 26.8 ± 7.4 years. Majority, 86 (73.5%), presented with loss of consciousness; 22 (18.8%) had seizures, 14 (13.2%) had headaches, and 13 (11.9%) had vomiting. Traditional vascular risk factors, hypertension (5.8%) and diabetes mellitus (2.5%) were uncommon. Mean GCS was 7 ± 4. The commonest cause was trauma in 101 (84.2%) patients. Lobar hemorrhage was the commonest, 99 (83.2%); 92 (81.4%) had ICH volume < 30 mL, and ventricular involvement was seen in 43 (36.1%). Median ICH score was 2. Higher odds of mortality were observed among the oldest age group (OR 4.30, 95% CI 1.23-14.98, = 0.022), higher ICH scores (OR 3.37, 95% CI 1.86-6.09, < 0.001), ICH volume > 30 mL (OR 16.40, 95% CI 5.35-50.26, < 0.001), ventricular extension (OR 5.60, 95% CI 2.14-14.68, < 0.001), and nontraumatic ICH etiology (OR 3.59, 95% CI 1.26-10.26, = 0.017). In our cohort, ICH was more common in young males; trauma being the leading cause of ICH. ICH resulted in significant morbidity and mortality in this population. Larger hemorrhages, ventricular involvement, and relatively older age were poor prognostic factors.
高血压是脑出血（ICH）最常见的病因。与其他年龄组相比，年轻人脑出血的表现、病因及预后可能有所不同。我们地区之前的文献描述了多种病因，与高血压的关系并不一致，而高血压是成年人原发性脑出血最常见的病因。我们旨在确定我们人群中年轻人脑出血的人口统计学模式、临床表现、潜在病因、影像学特征及预后。这是一项经机构审查委员会（IRB）批准的病历回顾研究，纳入了2016年1月至2020年12月期间的患者。将描述性的年轻人定义为15至45岁之间的人群，并进一步任意分为三个年龄组。在各亚组之间比较了各种人口统计学、临床和影像学特征，并进行了描述性和对比分析。共纳入120例患者；110例（91.7%）为男性。平均年龄为26.8±7.4岁。大多数患者，86例（73.5%）出现意识丧失；22例（18.8%）有癫痫发作，14例（13.2%）有头痛，13例（11.9%）有呕吐。传统血管危险因素，高血压（5.8%）和糖尿病（2.5%）并不常见。平均格拉斯哥昏迷量表（GCS）评分为7±4分。最常见的病因是创伤，101例（84.2%）患者如此。脑叶出血最常见，99例（83.2%）；92例（81.4%）脑出血体积<30毫升，43例（36.1%）出现脑室受累。脑出血评分中位数为2分。在年龄最大的年龄组中观察到更高的死亡几率（比值比[OR]4.30，95%置信区间[CI]1.23 - 14.98，P = 0.022），更高的脑出血评分（OR 3.37，95%CI 1.86 - 6.09，P < 0.001），脑出血体积>30毫升（OR 16.40，95%CI 5.35 - 50.26，P < 0.001），脑室扩展（OR 5.60，95%CI 2.14 - 14.68，P < 0.001），以及非创伤性脑出血病因（OR 3.59，95%CI 1.26 - 10.26，P = 0.017）。在我们的队列中，脑出血在年轻男性中更常见；创伤是脑出血的主要原因。脑出血在该人群中导致了显著的发病率和死亡率。更大的出血、脑室受累以及相对较大的年龄是不良预后因素。
