1Dr Allah Rakha,2Dr Ansa Batool, 3Dr Hidayat Ul Haq, 4Dr Jawad Khan, 5Dr Sobia Afreen
Predictors of Mortality and Neurological Recovery in Patients with Intracerebral Hemorrhage
Abstract:
Intracerebral hemorrhage (ICH) is a severe form of stroke characterized by bleeding directly into the brain parenchyma and is associated with substantial mortality and long-term neurological disability. Clinical severity, hematoma characteristics, intraventricular extension, age, level of consciousness, and early neurological deterioration are important determinants of outcome. Accurate identification of prognostic factors supports early risk stratification, treatment planning, and rehabilitation strategies. This study aimed to evaluate the major clinical, radiological, and management-related predictors of mortality and neurological recovery in patients with spontaneous intracerebral hemorrhage. A hospital-based observational study was conducted among adult patients diagnosed with spontaneous intracerebral hemorrhage. Patients were assessed at admission for demographic characteristics, neurological status, vital signs, comorbidities, laboratory findings, and hematoma characteristics on neuroimaging. Glasgow
Coma Scale, hematoma volume, hematoma location, intraventricular hemorrhage, hydrocephalus, and early neurological deterioration were evaluated as potential prognostic factors. Treatmentrelated variables, including intensive care management, blood pressure control, neurosurgical intervention, and complications, were also assessed. Mortality and neurological recovery were evaluated according to clinical outcome measures during hospitalization and follow-up where available. Data were analyzed descriptively and comparatively to identify factors associated with unfavorable outcomes. Poor neurological status at admission, greater hematoma volume, intraventricular extension, hydrocephalus, advanced age, early neurological deterioration, and severe systemic complications were associated with higher mortality and poorer neurological recovery. Patients with smaller hematomas, preserved consciousness, stable neurological status, and absence of intraventricular extension generally demonstrated more favorable functional recovery. Effective early management of blood pressure, timely recognition of neurological deterioration, and appropriate neurosurgical or intensive care intervention were associated with improved opportunities for neurological stabilization. Mortality and neurological recovery following intracerebral hemorrhage are influenced by a combination of baseline neurological
status, hematoma characteristics, systemic factors, and early clinical management. Early prognostic assessment using readily available clinical and radiological variables can assist clinicians in identifying high-risk patients and optimizing individualized management and rehabilitation.
GlobalHealth & Medicine. 2026; 8(3):319-331. Original Article
DOI:10.35772/ghm.2026.01071
Keywords
Intracerebral hemorrhage, mortality, neurological recovery, hematoma volume, Glasgow Coma Scale, intraventricular hemorrhage, prognostic factors, stroke outcome
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