By : Wardatul Nanda Fauza Zein

Identity number : 17174101

Departement of Neurology in Datu beru Hospital

Takengon Aceh
Objectives : To assess the risk factors leading to medical complications of
hemorrhagic stroke
Methods : an observasional at a tertiary care teaching hospital in Kadapa.
Excluded criteria : trauma brain, brain tumor, and observed to assess the risk
factors and complication
Results : out of 89% of identified at least 1 Prespecified complication.
Around 47% of subjects deceased, among which 64% were females.
Conclusions : Hypertension followed by diabetes melitus are the major risk
factors for complication of hemorrhagic stroke.
 Stroke is a clinical syndrome characterized by an acute loss of focal
brain function with symptoms lasting more than 24 h to early death.
Hemorrhagic Stroke (HS) is caused by leeding a blood vessel supplying the
brain. HS most commontly occur in association with hypertension.

Risk factors for stroke

1. Sociodemographic ( Age, Sex, Ethnicity, socioeconomic)
2. Biological
3. Lifestyle (Smoking, Alcohol, Inactivity, Diet)
4. Other conditions (DM, IHD, CAS)
5. Other factors (oral contraception)
The hospital mortality and
morbidity rate of patients The Medical
with acute stroke is 7,6% complications are
to 30%. Neurological barriers to optimal
death is 80% ( increased recovery with
intracranial pressure and estimated range from
subsequent herniation) and 40%-96% of patients
Non-neurological about
17%.
 Sample : Patients required from each department had at least 18 years of
age or older and clinical diagnoses of hemorrhagic stroke with a
neurological deficit occuring within 7 days.

 Exclusion criteria : Patients with trauma, brain tumor, ischemic stroke and
patient with incomplete follow-ups.

 Methode : an observasional study in Neurology. Enrolled patients had

clinical and laboratory information from their medical records. This journal
utilized a data collection form to assess risk factors and monitor the
incidence complication.

 Data : Sex, age, race, date of recruitment, diabetes, hypertension,

hypercholesterolemia, elevated triglyceride levels, lipoprotein,
GCS,Rankin scala, etc were also recorded
Complications
Neurological Recurrent stroke • Clinical features
lasting more than 24 h
Epileptic seizure • Clinical diagnosis of
focal and/or
generilized seizure

Infection Urinary track infection • Clinical symtoms of

urinary tract invention
or positive urine
Chest infection culture
• Crackles, fever or
Other infections radiografic evidence
• Any pyrexial illness
lasting more than 24 h
Immobility Falls • Fall regardless of
Pressure sore/skin break cause
• Skin break or necrosis
Psychological Depression • low mood
Miscellaneous • Documented
complication resulting
in a specific medical
or surgical
 From 288 patients, there
were 152 (52,8%) males
and 218 (75,7%) had
their first-ever stroke in
the age group of 60-80
years . One hundred and
twenty three (42,7%)
patients admitted to a
general neurology, 89
• Figure 1 (31%) to an emergency
ward and 76 (26,4%) to
general medical ward.
Table 3 Table 4
Risk factors in HS patients Proportion of hypertension
Risk Number Percentag among HS
Factor e (%) Hypertens Hypertens
ion in ion from
Hypertens 217 75,35
current pervious
ion
study [n retrospect
DM 76 26,39 (%)] ive study
(syed
Zulfiquar
AS et.al)
Men 105 62,1
Smoke 92 31,94 (n=152) (69,07)
Alcohol 88 30,56 Woman 112 64,7
(n=136) (82,70)
Obese 16 5,55
 Complication Number Percentage
Recurrent stroke 36 12.50
Epileptic seizures 24 8.33
Fall 65 22.57
Pain 12 4.17
Depression 8 2.78
Loss of muscle 112 38.89
control/paralysis
Speech problem 103 35.76
Swallowing problems 63 21.88
Deaths 136 47.22
DM 32 11.11
Hypertension 11 3.82
Constipation 22 7.63
Urinary tract infection 13 4.51
Chest infection 18 6.25
60

50

40

30 Male
Female
20

10

0
50-60 60-70 70-80
4.1 Risk factor

Hypertension is the
single most important
risk factor for DM, smoking, and alkohol
intracerebral hemorrhage. were similar risk for HS.
Out of 217 hypertension There is compelling
patient shows 203 evidence relating high
alcohol intake with a higher
patients were heaving
risk of ICH
blood pressure > 160/90
shows almost 7 fold
increased risk for HS
when compared to
normotensives.
 Mortality
Complications
Patients with HS are
generally at high risk of
The complications mortality (47,2%) was high
after occurance of from other studies the ranges
stroke was 75%. from 1,4% to 17%.
Among these that Hematoma expansions,
(47,2%), loss of edema formation, and intra-
ventricular hemorrhage
muscle control
leading to increased
(38,9%), speech intracranial pressure. Female
problem (35%), and are more prone to
seizures (8,33%). hemorrhagic stroke because
of high risk of hypertension.