Non-traumatic intracerebral hemorrhage in young adults living in Guayaquil, Ecuador (South America): Analysis of 151 patients

We studied 151 patients aged 15 to 44 years with nontraumatic intracerebral hemorrhage admitted to a large public hospital over a 10-year period. Patients were evaluated for an association of death or severe disability after the stroke with the following variables: sex, age, location, of the hemorrhage, and possible etiology. Lobar hemorrhages were found in 63 (41.7%) patients, putaminal hemorrhages in 39 (25.8%), posterior fossa hemorrhages in 24 (15.9%), and hemorrhages in other locations in 25 (16.6%). A possible etiology was determined in 109 (72.2%) patients. Hypertensive arteriolopathy accounted for 60 (39.7%) cases, rupture of a saccular aneurysm or a vascular malformation for 33 (21.9%), and other etiologies for 16 (10.6%). Thirty-four (22.5%) patients died after the acute event. The age of the patient, the location, and the etiology of the hemorrhage had no prognostic significance for mortality. In contrast, these factors predicted the degree of functional recovery in survivors. The best prognosis was noted in patients younger than 35 years with lobar hemorrhages of undetermined etiology, and the worst prognosis was noted in patients aged 35-44 years with putaminal or posterior fossa hemorrhages related to hypertensive arteriolopathy.