Influence of Intracerebral Hemorrhage Location on Incidence, Characteristics, and Outcome
Authors: Samarasekera Neshika , Fonville Arthur , Lerpiniere Christine , Farrall Andrew J. , Wardlaw Joanna M. , White Philip M. , Smith Colin , Al-Shahi Salman Rustam , Addison Anne , Ahmad Kate , Alhadad Syed , Andrews Peter , Bisset Elaine , Bodkin Peter , Bouhaidar Ralph , Brennan Paul , Campbell Brian , Chandran Siddharthan , Cook Helen , Davenport Richard , Dennis Martin , Derry Chris , Dodds Katrina , Doubal Fergus , Duncan Susan , Elder Andrew , Fitzpatrick Mike , Foley Peter , Fouyas Ioannis , Ghosh Sudipto , Gibson Rod , Gordon Claire , Grant Robin , Hewett Russell , Hughes Fiona , Hughes Mark , Hunt David , Hunter Neil , Ironside James , Liaquat Imran , Josephson Colin , Kamat Anant , Kealley Susan , Keir Sarah , Kerr Gillian , Kerrigan Simon , Keston Peter , King Matthew , Knight Richard , Macdonald Elizabeth , Mackay Graham , Macleod Donald , Macleod Malcolm , Maguire Conor , Makin Steven , Mathews Ashok , Maxwell Fiona , McClellan Stuart , Millar Tracey , Morris Zoe , Morse Tim , Mumford Colin , Murray Katherine , Myles Lynn , Nimmo Graham , Ng Yi , Pal Suvankar , Rannikmae Kristiina , Rhodes Jonathan , Ross Jerard , Russell Tim , Sandercock Peter , Sellar Robin , Shanmuganathan Mano , Shekhar Himanshu , Simms Henry , Sittampalam Mara , Soleiman Hamza , Spiers Helen , Statham Patrick , Stavrinos Neo , Stone Jon , Stuart Joyce , Sudlow Cathie , Summers David , Taylor Pat , Torgersen Antonia , van Dijke Margarethe , Walker Robert , Weller Belinda , Whiteley William , Whittle Ian , Will Robert , Young Wendy , Anderson Judith , Broadbent Seona , Butler Laura , Caesar Dave , Cantley Patricia , Carter Jonathan , Clegg Gareth , Coull Andrew , Crosswaite Alastair , Dear James , Dummer Simon , Duncan Fiona , Elder-Gracie Trish , Enright Kate , Fitzgerald Tom , Fothergill Jane , Frier Brian , Grant David , Gray Alasdair , Hart Simon , Henderson Robin , Jaap Alan , Leigh-Smith Simon , Jones Michael , Masson Moyra , McCallum Lynn , McKechnie Martin , McKillop Graham , Mead Gillian , Morley Wendy , Morrow Billie , Morrow Frank , Murchison Jon , Murphy Ross , Ng Jasmine , Ogundipe Olayinka , Patel Dilip , Pollock Alison , Reed Matthew , Roberts Geraint , Selvarajah Johann , Smith Randy , Stirling Claire , Turner Neil , Wilson Matthew , Yordanov Stanko , Bell Nicola , Chambers Sarah , Dewar Sandra , Farquhar Donald , Harmouche Ali , Jacob Ashok , Jackson Katherine , Knox Anne , McCafferty Jon , Moultrie Sam , Munang Latana , Noble Donald , Ramsay Scott , Spence Linda , Threlfall Bethany , Williams Adrian , Wilson James , Fitzgerald Alastair , Jamieson Andrew , Lange Peter , McIntosh Andrew , Morrison Lewis , Todd Iain 
Published: January 2015

Background and Purpose—

The characteristics of intracerebral hemorrhage (ICH) may vary by ICH location because of differences in the distribution of underlying cerebral small vessel diseases. Therefore, we investigated the incidence, characteristics, and outcome of lobar and nonlobar ICH.

Methods—

In a population-based, prospective inception cohort study of ICH, we used multiple overlapping sources of case ascertainment and follow-up to identify and validate ICH diagnoses in 2010 to 2011 in an adult population of 695 335.

Results—

There were 128 participants with first-ever primary ICH. The overall incidence of lobar ICH was similar to nonlobar ICH (9.8 [95% confidence interval, 7.7–12.4] versus 8.6 [95% confidence interval, 6.7–11.1] per 100 000 adults/y). At baseline, adults with lobar ICH were more likely to have preceding dementia (21% versus 5%;
P
=0.01), lower Glasgow Coma Scale scores (median, 13 versus 14;
P
=0.03), larger ICHs (median, 38 versus 11 mL;
P
<0.001), subarachnoid extension (57% versus 5%;
P
<0.001), and subdural extension (15% versus 3%;
P
=0.02) than those with nonlobar ICH. One-year case fatality was lower after lobar ICH than after nonlobar ICH (adjusted odds ratio for death at 1 year: lobar versus nonlobar ICH 0.21; 95% confidence interval, 0.07–0.63;
P
=0.006, after adjustment for known predictors of outcome). There were 4 recurrent ICHs, which occurred exclusively in survivors of lobar ICH (annual risk of recurrent ICH after lobar ICH, 11.8%; 95% confidence interval, 4.6%–28.5% versus 0% after nonlobar ICH; log-rank
P
=0.04).

Conclusions—

The baseline characteristics and outcome of lobar ICH differ from other locations.