Factors Which Influence Prognosis of Intracranial Haemorrhage

Created on Tue, 06/30/2015 - 22:38
Last updated on Thu, 09/24/2015 - 03:43

This has come up in Question 25 from the first paper of 2014. The examiners asked, "List five validated features affecting prognosis for patients with F" - with F being a huge frontotemporal bleed.

The college answer referred to an "intracranial haemorrhage score". There are a few of those.

The specific scoring system referred to in the official model answer was probably the modified Essen ICH score rather than the original ICH score. The Essen people added the NIH-SS score and intraventricular extension to the list of scored variables in order to refine the system, apparently with an improvement in its predictive value.

One can view the original system here and Essen scoring system here. Detailed familiarity with them is not essential; however one should recall that the following variables suggest a poor prognosis:

The FUNC score is another system, which appears to accurately identify those patients who will have a low chance of neurological recovery at discharge; it does not incorporate the location of the ICH.

 

References

Hemphill, J. Claude, et al. "The ICH score a simple, reliable grading scale for intracerebral hemorrhage." Stroke 32.4 (2001): 891-897.

Weimar, Christian, Jens Benemann, and H. C. Diener. "Development and validation of the Essen intracerebral haemorrhage score." Journal of Neurology, Neurosurgery & Psychiatry 77.5 (2006): 601-605.

Rost, Natalia S., et al. "Prediction of Functional Outcome in Patients With Primary Intracerebral Hemorrhage The FUNC Score." Stroke 39.8 (2008): 2304-2309.

Garrett, John S., et al. "Validation of Clinical Prediction Scores in Patients with Primary Intracerebral Hemorrhage." Neurocritical care 19.3 (2013): 329-335.