Early neurological change in patients with spontaneous supratentorial intracerebral hemorrhage

The frequency and causes of neurological change that occurs in patients within 24 hours after the onset of intracerebral hemorrhage (ICH), as well as their relationship to outcome, have seldom been reported. This study evaluated 184 patients with supratentorial ICH and neurological deterioration or improvement; measuring their level of consciousness (LOC) and motor skills the day after admission using the National Institutes of Health Stroke Scale. Nineteen patients (10%) deteriorated and 114 (62%) improved. Patient age, hematoma volume, and change in hematoma volume were independent predictors of early neurological improvement (p < 0.05). Independent predictors of 1-month functional outcome were age, LOC score at admission, motor score at admission, and change in motor score the day after admission (p < 0.05). Approximately 70% of the patients showed early neurological change. Observing early changes in hemiparesis was important for predicting functional outcome.