[Intracerebral haemorrhage in a referral hospital in the central-western region of Mexico]. / Hemorragia intracerebral en un hospital de referencia de la region centro-occidente de Mexico.

INTRODUCTION: Intracerebral haemorrhage (ICH) has received little attention in studies in Mexico. Isolated reports talk of high frequency, its importance as a disorder among young people, its being mainly located in the lobar regions and a high rate of recurrence. AIMS: The objective of this study was to characterise the clinical, radiological, therapeutic and prognostic spectrum of ICH in a general hospital in the central-western region of Mexico. PATIENTS AND METHODS: The study involved 270 consecutive patients over the age of 15 years with spontaneous ICH who were hospitalised in the Neurology and Neurosurgical Service in the Antiguo Hospital Civil de Guadalajara between the years 2000 and 2002. Their clinical history and progression was known at least on discharge from the hospital. RESULTS: The mean age was 63 years (12% under 40 years old) with no predominance according to gender (53% males). Arterial hypertension was the main risk factor in 69%, followed by obesity in 38%. There were no differences in the Glasgow administered on admission in three pre-established subgroups. The ICH was ganglionic in 64% of cases and lobar in 24%. Arterial hypertension was the principal cause of ICH in 76%. Ventricular aperture was noted in 53%. All the patients were treated in a general ward. Mortality in the acute phase occurred in 49%, although a poor progression was observed in 83%. Overall recurrence was 13%. Outpatient follow-up was poor. CONCLUSIONS: ICH shares most of the features reported in Anglo-Saxon series including aetiology and location. In our population, mortality and recurrence are high with important sequelae. The high frequency of ICH (40%) may represent a bias in the selection of hospitals.

Hemorragia intracerebral en un hospital de referencia de la región centro-occidente de México / Intracerebral haemorrhage in a referral Hospital in the central-Western región of Mexico

Introducción. La hemorragia intracerebral (HIC) se ha estudiado escasamente en México. Algunos comunicados aislados señalan una elevada frecuencia, importante afectación en jóvenes, mayor localización lobar y alta recurrencia. Objetivos. Caracterizar el espectro clínico, radiológico, terapéutico y pronóstico de la HIC en un hospital general de la región centro-occidente de México. Pacientes y métodos. Se incluyeron 270 pacientes consecutivos mayores de 15 años con HIC espontánea ingresados en el Servicio de Neurología y Neurocirugía del Antiguo Hospital Civil de Guadalajara, entre los años 2000 y 2002. Todos tenían historia clínica y una evolución conocida, al menos, hasta el alta hospitalaria. Resultados. La edad promedio fue de 63 años (12% menores de 40 años) sin predominio de sexo (53% hombres). La hipertensión arterial fue el principal factor de riesgo (69%), seguida de la obesidad (38%). No hubo diferencia en el Glasgow al ingreso en tres subgrupos preestablecidos. La localización de la HIC fue ganglionar en el 64% y lobar en el 24%. La hipertensión arterial fue la principal causa de HIC en el 76%. La apertura ventricular se consignó en un 53%. Todos los pacientes se trataron en la sala general. La mortalidad en fase aguda se dio en el 49%, aunque se consignó una mala evolución en el 83%. La recurrencia global fue de 13%. El seguimiento por consulta externa es pobre. Conclusiones. La HIC comparte la mayoría de las características comunicadas en series anglosajonas con inclusión de etiología y localización. En nuestra población, la mortalidad y la recurrencia son altas, con secuelas importantes. La elevada frecuencia de HIC (40%) puede representar un sesgo de selección hospitalaria (AU)

Introduction. Intracerebral haemorrhage (ICH) has received little attention in studies in Mexico. Isolated reports talk of high frequency, its importance as a disorder among young people, its being mainly located in the lobar regions and a high rate of recurrence. Aims. The objective of this study was to characterise the clinical, radiological, therapeutic and prognostic spectrum of ICH in a general hospital in the central-western region of Mexico. Patients and methods. The study involved 270 consecutive patients over the age of 15 years with spontaneous ICH who were hospitalised in the Neurology and Neurosurgical Service in the Antiguo Hospital Civil de Guadalajara between the years 2000 and 2002. Their clinical history and progression was known at least on discharge from the hospital. Results. The mean age was 63 years (12% under 40 years old) with no predominance according to gender (53% males). Arterial hypertension was the main risk factor in 69%, followed by obesity in 38%. There were no differences in the Glasgow administered on admission in three pre-established subgroups. The ICH was ganglionic in 64% of cases and lobar in 24%. Arterial hypertension was the principal cause of ICH in 76%. Ventricular aperture was noted in 53%. All the patients were treated in a general ward. Mortality in the acute phase occurred in 49%, although a poor progression was observed in 83%. Overall recurrence was 13%. Outpatient follow-up was poor. Conclusions. ICH shares most of the features reported in Anglo-Saxon series including aetiology and location. In our population, mortality and recurrence are high with important sequelae. The high frequency of ICH (40%) may represent a bias in the selection of hospitals (AU)