Primary intracerebral haemorrhage in the Jyväskylä region, central Finland, 1985-89: incidence, case fatality rate, and functional outcome.

The age and sex specific incidence rates, the case fatality rates, and the functional outcome of patients with primary intracerebral haemorrhage occurring in a population of 116,000 during a period of four years four months are presented. A total of 158 patients were identified, the diagnosis was confirmed in 78% by CT, and in 22% by necropsy. The crude annual incidence rate was 31/100,000 population, the age specific rates increased from two to 222/100,000 from the age of 30-39 to over 80 years. Men had higher incidence rates between the ages of 40 and 79 years. The short term case fatality rate was high, 27% of patients dying during the first day after onset of symptoms, and 50% were dead at 30 days. After the first month the probability of survival did not differ from an age- and sex-matched average population. Large haematoma volume had an adverse effect on the short term, old age (greater than 70 years) on the long term survival. Ventricular extension, especially when combined with hydrocephalus was a bad omen for short term survival. Infratentorial and large basal ganglionic haematomas, and primary intraventricular haemorrhage carried a worse prognosis than haematomas of other locations. At the end of a median 32 month follow up 55 (35%) of the patients were alive, 51% of these were independent in activities of daily living, 45% were dependent on outside help, and 4% needed constant nursing care. Old age (greater than 70 years), but not the haematoma volume or location, was associated with a poor functional recovery.