Analysis of Locations and Causes of Intracerebral Hemorrhage in Young People

Abstract

Background and Objectives : It has been known that the intracerebral hemorrhage (ICH) in young people has its own peculiar causes and affected regions. We investigated the locations and causes of ICH in Korean patients less than 40 years of age. Patients and Methods : We retrospectively reviewed the medical records of 145 subjects (mean age, 27 years; range, 4 months to 40 years) admitted to Chonnam University Hospital from 1989 to 1998. All of them had an ICH in neuroimaging study. The primary subarachnoid and traumatic hemorrhages were excluded. We analyzed the locations and causes of ICH. Results : The locations of ICH were lobar (47%), basal ganglia/thalamus (23%), ventricular (13%) and others (16%). The most common cause of ICH was vascular malformation (49%) including arteriovenous malformation, cavernous angioma and moyamoya disease. The incidence of cryptogenic and hypertensive ICH were 10% and 6%, respectively. With the increase of age, the incidence of vascular malformation decreased (p<0.01) and that of basal ganglia/thalamic ICH increased (p<0.01). Interestingly moyamoya disease was one of the major causes of ICH in our patients (10%), resulting in basal ganglia ICH or intraventricular hemorrhage. Conclusions:ICH in young people is mainly lobar in location and most of them caused by vascular malformation. ICH caused by hypertension is located in the basal ganglia/thalamus in most of the cases. Angiography should be an essential part of the evaluation in young patients with ICH. Korean Journal of Stroke 1999;1(2): 169~174