Intracerebral hemorrhage epidemiology and demographics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

The overall incidence of intracerebral hemorrhage (ICH) ranges from 12 to 31 per 100,000 population.^[1] The incidence of intracerebral hemorrhage gets doubled every 10 years after age 35 every, but the prevalence and incidence does not vary by gender.^[2]^[3] The incidence of intracerebral hemorrhage is the highest in Asians.^[4]

Epidemiology

Incidence

The overall incidence of intracerebral hemorrhage (ICH) ranges from 12 to 31 per 100,000 population.^[1]

Age

The incidence of intracerebral hemorrhage (ICH) increases with age, after age 35 every 10 years, the risk of having ICH is getting doubled.^[3]
Primary lobar hemorrhages, due to cerebral amyloid angiopathy, are typically seen in elderly.
Younger patients may also develop lobar hemorrhages, but in such cases they usually have an underlying lesion such as cerebral arteriovenous malformation (AVM).^[5]

Gender

The prevalence and incidence of intracerebral hemorrhage does not vary by gender.^[2]

Race

The incidence of intracerebral hemorrhage is the highest in Asians.^[4]
- In Japan, the incidence of intracerebral hemorrhage is 43 to 47 cases per 100,000 Japanese.^[6]
In African Americans, the incidence of intracerebral hemorrhage is 48 cases per 100,000 persons.
In Whites, the incidence of intracerebral hemorrhage is 26 cases per 100,000 persons. ^[7]
The incidence of Intracerebral hemorrhage is higher in Mexican Americans than non-Hispanic whites.^[8]

Case fatality rate

The 30-day case fatality rate of intracerebral hemorrhage (ICH) ranges from 37,000 to 52,000 cases per 100,000 individuals.^[9]^[10]
Death at 1 year for intracerebral hemorrhage (ICH) varies by location:^[11]
- Brain steam 65,000 cases per 100,000 individuals
- Lobar ICH 57,000 cases per 100,000 individuals
- Deep ICH 50,000 cases per 100,000 individuals
- Cerebellar ICH 42,000 cases per 100,000 individuals

References

↑ ^1.0 ^1.1 Gebel JM, Broderick JP (2000). “Intracerebral hemorrhage”. Neurol Clin. 18 (2): 419–38. PMID 10757834.
↑ ^2.0 ^2.1 van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ (2010). “Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis”. Lancet Neurol. 9 (2): 167–76. doi:10.1016/S1474-4422(09)70340-0. PMID 20056489.
↑ ^3.0 ^3.1 Stein M, Misselwitz B, Hamann GF, Scharbrodt W, Schummer DI, Oertel MF (2012). “Intracerebral hemorrhage in the very old: future demographic trends of an aging population”. Stroke. 43 (4): 1126–8. doi:10.1161/STROKEAHA.111.644716. PMID 22282880.
↑ ^4.0 ^4.1 Inagawa T, Ohbayashi N, Takechi A, Shibukawa M, Yahara K. Primary intracerebral hemorrhage in Izumo City, Japan: incidence rates and outcome in relation to the site of hemorrhage. Neurosurgery. 2003; 53: 1283–1298
↑ Falcone GJ, Biffi A, Brouwers HB, Anderson CD, Battey TW, Ayres AM; et al. (2013). “Predictors of hematoma volume in deep and lobar supratentorial intracerebral hemorrhage”. JAMA Neurol. 70 (8): 988–94. doi:10.1001/jamaneurol.2013.98. PMC 3808840. PMID 23733000.
↑ Tanaka H, Ueda Y, Date C, Baba T, Yamashita H, Hayashi M, Shoji H, Owada K, Baba K, Shibuya M, Kon T, Detels R. Incidence of stroke in Shibata, Japan: 1976–1978. Stroke. 1981; 12: 460–466
↑ Flaherty ML, Woo D, Haverbusch M, Sekar P, Khoury J, Sauerbeck L; et al. (2005). “Racial variations in location and risk of intracerebral hemorrhage”. Stroke. 36 (5): 934–7. doi:10.1161/01.STR.0000160756.72109.95. PMID 15790947.
↑ Morgenstern LB, Smith MA, Lisabeth LD, Risser JM, Uchino K, Garcia N; et al. (2004). “Excess stroke in Mexican Americans compared with non-Hispanic Whites: the Brain Attack Surveillance in Corpus Christi Project”. Am J Epidemiol. 160 (4): 376–83. doi:10.1093/aje/kwh225. PMC 1524675. PMID 15286023.
↑ Dennis, Martin S., et al. “Long-term survival after first-ever stroke: the Oxfordshire Community Stroke Project.” Stroke 24.6 (1993): 796-800.
↑ Kleindorfer D., Broderick J., Khoury J., et al: The unchanging incidence and case-fatality of stroke in the 1990s: a population-based study. Stroke 2006; 37: pp. 2473-2478
↑ Woo, Daniel, and Joseph P. Broderick. “Spontaneous intracerebral hemorrhage: epidemiology and clinical presentation.” Neurosurgery clinics of North America 13.3 (2002): 265-279.

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[pmid10757834-1] 1.0 ^1.1 Gebel JM, Broderick JP (2000). “Intracerebral hemorrhage”. Neurol Clin. 18 (2): 419–38. PMID 10757834.

[pmid20056489-2] 2.0 ^2.1 van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ (2010). “Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis”. Lancet Neurol. 9 (2): 167–76. doi:10.1016/S1474-4422(09)70340-0. PMID 20056489.

[pmid22282880-3] 3.0 ^3.1 Stein M, Misselwitz B, Hamann GF, Scharbrodt W, Schummer DI, Oertel MF (2012). “Intracerebral hemorrhage in the very old: future demographic trends of an aging population”. Stroke. 43 (4): 1126–8. doi:10.1161/STROKEAHA.111.644716. PMID 22282880.

[Inagawa-4] 4.0 ^4.1 Inagawa T, Ohbayashi N, Takechi A, Shibukawa M, Yahara K. Primary intracerebral hemorrhage in Izumo City, Japan: incidence rates and outcome in relation to the site of hemorrhage. Neurosurgery. 2003; 53: 1283–1298

[pmid23733000-5] Falcone GJ, Biffi A, Brouwers HB, Anderson CD, Battey TW, Ayres AM; et al. (2013). “Predictors of hematoma volume in deep and lobar supratentorial intracerebral hemorrhage”. JAMA Neurol. 70 (8): 988–94. doi:10.1001/jamaneurol.2013.98. PMC 3808840. PMID 23733000.

[Tanaka-6] Tanaka H, Ueda Y, Date C, Baba T, Yamashita H, Hayashi M, Shoji H, Owada K, Baba K, Shibuya M, Kon T, Detels R. Incidence of stroke in Shibata, Japan: 1976–1978. Stroke. 1981; 12: 460–466

[pmid15790947-7] Flaherty ML, Woo D, Haverbusch M, Sekar P, Khoury J, Sauerbeck L; et al. (2005). “Racial variations in location and risk of intracerebral hemorrhage”. Stroke. 36 (5): 934–7. doi:10.1161/01.STR.0000160756.72109.95. PMID 15790947.

[pmid15286023-8] Morgenstern LB, Smith MA, Lisabeth LD, Risser JM, Uchino K, Garcia N; et al. (2004). “Excess stroke in Mexican Americans compared with non-Hispanic Whites: the Brain Attack Surveillance in Corpus Christi Project”. Am J Epidemiol. 160 (4): 376–83. doi:10.1093/aje/kwh225. PMC 1524675. PMID 15286023.

[Dennis-9] Dennis, Martin S., et al. “Long-term survival after first-ever stroke: the Oxfordshire Community Stroke Project.” Stroke 24.6 (1993): 796-800.

[Kleindorfer-10] Kleindorfer D., Broderick J., Khoury J., et al: The unchanging incidence and case-fatality of stroke in the 1990s: a population-based study. Stroke 2006; 37: pp. 2473-2478

[Woo-11] Woo, Daniel, and Joseph P. Broderick. “Spontaneous intracerebral hemorrhage: epidemiology and clinical presentation.” Neurosurgery clinics of North America 13.3 (2002): 265-279.

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