Abstract 3858: Evaluation of Serial Neuroimaging in Patients with Intracerebral Hemorrhage

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Tanzila Shams ◽  
Prachi Mehndiratta ◽  
Pichet Termsarasab ◽  
Hesham Masoud ◽  
Siddharth Sehgal ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Intracerebral Hemorrhage ◽  
No Value ◽  
Retrospective Chart Review ◽  
Care Plan ◽  
Hematoma Expansion ◽  
Imaging Studies ◽  
Imaging Characteristics ◽  
Neuroimaging Study ◽  
The Impact

Introduction: The availability of sophisticated neuroimaging has led to increased utilization of imaging studies, particularly at comprehensive stroke centers. This increase in advanced imaging contributes to healthcare costs and has been questioned in this era of reducing reimbursement. Hypothesis: Multiple neuroimaging studies have limited impact in determining the plan of care for most patients with intracerebral hemorrhage. Methods: An IRB-approved retrospective chart review of all patients with Intracerebral Hemorrhage (ICH, ICD 431) treated at UH-CMC in 2010 collected data on demographics, number of neuroimaging studies and imaging characteristics, and the impact of testing on determining a medical or surgical plan of care. Hemorrhage location dictated one of two groups: basal ganglia and thalamus (BG) versus IVH alone, infratentorial and lobar (NBG). Results: Data was available on 120 (86%) of patients; 74 (62%) were male. Mean volume of ICH on initial CT was significantly smaller at 8.5±11.7cc in 41 BG patients vs 63±27cc in 79 NBG patients (p=0.01). The decision to pursue surgical treatment (extraventricular drainage in 14, craniotomy in 9, or both in 4) was determined prior to a third neuroimaging study. Three or more neuroimaging studies were obtained in 56% of BG and 59% of NBG patients. Hematoma expansion was less likely to occur in BG vs NBG patients, both for significant hematoma expansion (>33% or +12.5cc increase, 5% vs 22%, p=0.05) and nonsignificant hematoma expansion (10-33% increase, 2.4% vs 8.9%, p=0.27). Hematoma expansion was exclusively within the first 2 imaging studies for BG patients but occurred in a delayed fashion in 3 (4%) of NBG patients. MRI was obtained in 17% of BG and 44% of NBG patients; only in 3 of the NBG patients did it identify a vascular malformation which led to surgery in 1 patient. Conclusion: Although more than half of patients with intracerebral hemorrhage underwent three or more neuroimaging studies, 95% of patients’ care plan decisions were determined by the first, and to a lesser extent, the second neuroimaging study. Serial neuroimaging after the second study was of no value in patients with small basal ganglia hemorrhages and impacted the care plan in less than 10% of patients with hemorrhages in alternate locations. Our data suggests many neuroimaging studies can be safely omitted.

Abstract TP358: Prehospital Diagnosis of Intracerebral Hemorrhage in a Mobile Stroke Treatment Unit

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Daniel Vela-Duarte ◽  
Ramnath Santosh Ramanathan ◽  
Atif Zafar ◽  
Ather Taqui ◽  
Stacey Winners ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Hematoma Expansion ◽  
Hospital Treatment ◽  
Treatment Team ◽  
Hematoma Volume ◽  
Treatment Unit ◽  
Stroke Treatment ◽  
Imaging Characteristics ◽  
Mobile Stroke Unit ◽  
The Impact

Introduction: The mobile stroke unit (MSTU) is an on-site pre-hospital treatment team that incorporates laboratory and CT scanner and reduces times to treatment for ischemic stroke thrombolysis. The impact of MSTU on treatment and outcomes of intracerebral hemorrhage (ICH) remains unknown. We report our initial experience with ICH encountered on MSTU. Hypothesis: ICH can be quickly identified using MSTU. Hypertension and coagulopathy are common in ICH evaluated on MSTU. Methods: We identified ICH cases from the prospectively collected database encounters. Demographics, clinical features, MSTU imaging and repeat imaging characteristics were reviewed. Initial and follow-up hematoma volume was calculated by the ABC/2 method. Results: Of 295 encounters on MSTU from July 2014 to July 2015, 20 (6.7%) had intracranial hemorrhage, which comprised of 17 intracerebral, 1 subarachnoid and 2 subdural hemorrhages. Median time to CT diagnosis of ICH from emergency medical dispatch was 31 minutes (interquartile range (IQR) 28-36) and that from last known well was 118 minutes (IQR 39-301). Of the 17 ICH patients, 15 (88%) were hypertensive, with a mean systolic blood pressure of 178.1 and diastolic 91.0 mm Hg. Five (29.4%) individuals were found with INR>1.4, 1 of whom received 4-factor prothrombin complex concentrate. Median NIH Stroke Scale was 11 (IQR 7.5-14.5), and median hematoma volume was 10.7 cc (IQR 4.3-30.8). One patient had significant hematoma expansion as defined by >6 cc or 33% relative volume increase. Conclusions: Over 5% of the cases evaluated in the unit presented with ICH, most of whom were hypertensive and had small hematoma volume. MSTU enables early diagnosis of ICH after activation of emergency system, can provide early treatment, and appropriate triage.

Abstract WP418: Characteristic of Intracerebral Hemorrhage Related to Direct Oral Anticoagulant versus Warfarin: Results From the PASTA Registry

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Satoshi Suda ◽  
Yasuyuki Iguchi ◽  
Shigeru Fujimoto ◽  
Yoshiki Yagita ◽  
Takayuki Mizunari ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Oral Anticoagulant ◽  
Hematoma Expansion ◽  
Direct Oral Anticoagulant ◽  
Registry Study ◽  
Stroke Patients ◽  
Hematoma Volume ◽  
Imaging Characteristics ◽  
Warfarin Treatment ◽  
Patient Enrollment

Background and Purpose: The characteristics of direct oral anticoagulant (DOAC)-related intracerebral hemorrhage (ICH) have not been fully clarified. We planned to recruit patients prospectively and to investigate the characteristics and outcomes in patients with ICH receiving direct oral anticoagulant (DOAC) and warfarin treatment. Methods: The prospective analysis of stroke patients taking anticoagulants (PASTA) registry study is an observational, multicenter, prospective registry of stroke patients receiving OAC. Patient enrollment started in April 2016 at 25 tertiary centers across Japan. We compared imaging, clinical characteristics, and discharge modified Rankin Scale (mRS) between DOAC- and warfarin-related ICH patients with atrial fibrillation (AF). Results: A total of 154 patients (51 women; median age 77 [quartiles 69-87] years) were analyzed. Of these, 111 patients (72%) received prior DOAC treatment and the remaining 43 (28%) received prior warfarin treatment (Fig. A, B and C). There were no relevant differences in clinical and hematoma characteristics between DOAC- and warfarin-related ICH regarding baseline hematoma volume (median [quartiles]: DOAC, 11 [5-23] mL vs. warfarin, 12 [5-30] mL; P =0.95), rate of hematoma expansion (DOAC, 12/111 [11%] vs. warfarin, 4/43 [9%]; P =0.80), rate of subcortical hemorrhage (DOAC, 15/111 [11%] vs. warfarin, 10/43 [9%]; P =0.80) and the proportion of patients with unfavorable outcome (mRS, 4-6: DOAC 76/108 [70%] vs. warfarin 23/38 [61%]; P =0.26). Cerebral microbleeds (CMBs) were detected more frequently in DOAC group than in warfarin (47/76 [62%] vs. 11/32 [34%]; P <0.01). Subgroup analyses showed that type of DOAC agent did not result in relevant differences in imaging characteristics or outcome (Fig. D and E). Conclusions: Our results showed that there were no significant differences in hematoma characteristics and functional outcome among AF patients with DOAC- or warfarin-related ICH.

Abstract WP302: Racial Differences in Imaging Characteristics and Risk Factors for Primary Intracerebral Hemorrhage: Final Results from the DECIPHER Study

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Chelsea S Kidwell ◽  
Laura German ◽  
Ravi S Menon ◽  
Nawar Shara ◽  
M. Christopher Gibbons ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intracerebral Hemorrhage ◽  
Racial Differences ◽  
Demographic Data ◽  
Black Communities ◽  
Imaging Data ◽  
Natural History Study ◽  
Imaging Characteristics ◽  
Primary Hemorrhage ◽  
The Impact

Background: Previous studies have reported racial differences in the incidence, location and risk factors for primary intracerebral hemorrhage (ICH). We now report differences in imaging characteristics and risk factors for ICH from the DiffErenCes in the Imaging of Primary Hemorrhage based on Ethnicity or Race (DECIPHER) study. Methods: DECIPHER is a longitudinal, multicenter, MRI-based, natural history study of racial differences in primary ICH. Inclusion criteria were: primary ICH, age ≥ 18, baseline and 1 year MRI scan obtained. Clinical and demographic data were collected on all subjects. Results: A total of 193 subjects of black or white race were enrolled. Subject characteristics overall and by race are provided in the table. Black subjects were younger, had a higher rate of hypertension, cocaine use, and were more frequently smokers. White subjects had a higher rate of hyperlipidemia. A lobar ICH location was more frequent in the white subjects, while infratentorial hemorrhages were more common in blacks. 60% of blacks had 1 or more microbleeds compared to 52% of whites (NS), and blacks tended to have more severe white matter disease. Conclusions: In the DECIPHER study, there were significant racial differences both in the risk factors for primary ICH and in the imaging characteristics. Compared to whites, blacks have a greater rate of hypertension, as well as cocaine and tobacco use. Imaging findings are indicative of a more severe underlying small vessel vasculopathy in the black cohort. The risk factor information may be used to enhance prevention programs tailored for black communities at risk of ICH, while imaging data may provide a useful biomarker to assess the impact of these interventions.

scholarly journals Different Effects of Hematoma Expansion on Short-Term Functional Outcome in Basal Ganglia and Thalamic Hemorrhages

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Lijing Deng ◽  
Kai Chen ◽  
Liu Yang ◽  
Zhaoxu Deng ◽  
Haijun Zheng
Keyword(s):  
Basal Ganglia ◽  
Functional Outcome ◽  
Hematoma Expansion ◽  
Short Term ◽  
Poor Functional Outcome ◽  
Predictive Values ◽  
Relative Growth ◽  
Poor Outcome ◽  
Absolute Growth ◽  
The Impact

Purpose. To investigate the impact of hematoma expansion (HE) on short-term functional outcome of patients with thalamic and basal ganglia intracerebral hemorrhage. Methods. Data of 420 patients with deep intracerebral hemorrhage (ICH) that received a baseline CT scan within 6 hours from symptom onset and a follow-up CT scan within 72 hours were retrospectively analyzed. The poor functional outcome was defined as modified   Rankin   score   mRS > 3 at 30 days. Receiver operating characteristic (ROC) curves for relative and absolute growth of HE were generated and compared. Multivariable logistic regression models were used to analyze the impact of HE on the functional outcome in basal ganglia and thalamic hemorrhages. The predictive values for different thresholds of HE were calculated, and correlation coefficient matrices were used to explore the correlation between the covariables. Results. Basal ganglia ICH showed a higher possibility of absolute hematoma growth than thalamic ICH. The area under the curve (AUC) for absolute and relative growth of thalamic hemorrhage was lower than that of basal ganglia hemorrhage (AUC 0.71 and 0.67, respectively) in discriminating short-term poor outcome with an AUC of 0.59 and 0.60, respectively. Each threshold of HE independently predicted poor outcome in basal ganglia ICH ( P < 0.001 ), with HE > 3   ml and > 6 ml showing higher positive predictive values and accuracy compared to HE > 33 % . In contrast, thalamic ICH had a smaller baseline volume (BV, 9.55 ± 6.85   ml ) and was more likely to initially involve the posterior limb of internal capsule (PLIC) (85/153, 57.82%), and the risk of HE was lower without PLIC involvement (4.76%, P = 0.009 ). Therefore, in multivariate analysis, the effect of thalamic HE on poor prognosis was largely replaced by BV and the involvement of PLIC, and the adjusted odds ratios (ORs) of HE was not significant ( P > 0.05 ). Conclusion. Though HE is a high-risk factor for short-term poor functional outcome, it is not an independent risk factor in thalamic ICH, and absolute growth is more predictive of poor outcome than relative growth for basal ganglia ICH.

Abstract WP415: Cigarette Smoking as Risk Factor for Hematoma Expansion in Primary Intracerebral Hemorrhage: Analysis From a Randomized Clinical Trial

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Shahram Majidi ◽  
Lydia Foster ◽  
Christopher P Kellner ◽  
Jose I Suarez ◽  
Adnan I Qureshi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cigarette Smoking ◽  
Intracerebral Hemorrhage ◽  
Smoking Status ◽  
Hematoma Expansion ◽  
Primary Analysis ◽  
Significant Difference ◽  
Former Smokers ◽  
Gcs Score ◽  
The Impact

Background: Cigarette smoking is a well-known risk factor for ischemic and hemorrhagic stroke. We evaluated the impact of smoking status on hematoma expansion and clinical outcome in patients with primary intracerebral hemorrhage (ICH). Methods: This is a post hoc exploratory analysis of Antihypertensive Treatment at Acute Cerebral Hemorrhage(ATACH)-2 trial. Patients with ICH were randomized into intensive blood pressure lowering(SBP: <139 mmHg) versus Baseline characteristics were compared based on smoking status. Analysis of outcome measures was adjusted for covariates included in the ATACH-2 primary analysis or those associated with smoking status. Results: Of total of 914 patients in the trial with known smoking status, 439 (48%) patients were ever-smokers (264 current smokers and 175 former smokers). Current and former smokers were younger and more likely to be male. There was no difference in the baseline Glasgow Coma Scale(GCS) score and initial hematoma size based on smoking status. Ever-smokers had higher rate of thalamic hemorrhage (42% vs 34%) and intraventricular hemorrhage (29% vs 23%); this rate was highest among former smokers (49% and 35%, respectively). Ever-smokers had higher rate of hematoma expansion in 24 hour [adjusted RR (95% CI): 1.46; (1.05 -2.03)] compared to non-smokers after adjusting for confounding factors. There was no significant difference in the rate of death and disability at 90 days between the two groups [adjusted RR; (95% CI): 1.18; (0.93 -1.50)]. Conclusions: Our analysis demonstrates cigarette smoking as an independent predictor for hematoma expansion. There was no significant difference in death and disability based on smoking status.

Abstract TP349: Improving Utilization of ICU Care: Change in Intracerebral Hemorrhage Admission Protocol at a Comprehensive Stroke Center

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Parneet Grewal ◽  
Deborah M Lynch ◽  
Anjali Asthana ◽  
Rhea Shrivastava ◽  
James J Conners
Keyword(s):  
Intracerebral Hemorrhage ◽  
External Ventricular Drain ◽  
Admission Rate ◽  
Retrospective Chart Review ◽  
Hematoma Expansion ◽  
Neurosurgical Procedures ◽  
Icu Admission ◽  
Coagulation Abnormalities ◽  
Ich Score ◽  
Gcs Score

Objectives: Non traumatic intracerebral hemorrhage (ICH) is responsible for 10-20% of acute stroke events and carries significant mortality concern. The protocol at our comprehensive stroke centers (CSC) is to admit all ICH patients to Neurosciences Intensive Care Unit (NSICU). We also have a stroke Intermediate Care Unit (IMCU) at our hospital which is a dedicated stroke unit where patients can be closely monitored and maintained on IV nicardipine. Optimal bed utilization is essential at our busy referral center. We aimed to develop criteria to identify ICH patients at low risk for clinical deterioration who could be admitted directly to our IMCU rather than the NSICU thereby improving overall utilization of monitored beds. Methods: Retrospective chart review for patients admitted between July 2018-Dec 2018 was performed. Age, sex, race, presenting Glasgow coma scale (GCS), ICH score, ICH volume, presence of IVH and location of the hemorrhage was documented. Patients who did not need any neurosurgical procedures (external ventricular drain, craniectomy or hematoma evacuation) and were not documented to have acute respiratory failure during their admission were considered appropriate for IMCU admission and were further assessed for hematoma expansion to determine stability throughout their hospital course. Results: 118 patients with ICH were included in the analysis, out of which 61 patients were suitable for IMCU admission. On univariable analysis, patients that had lower ICH scores (0.6±0.7 vs 2.5±0.9) and higher GCS score (14.1±1.4 vs 7.8±3.7) did not need any acute intervention. In this group of patients, only 9 (14.7%) patients had hematoma expansion documented out of which 6 (67%) patients had coagulation abnormalities on admission either due to medications or low platelet count. Conclusions: We conclude that the patients who had admission ICH score < 2, GCS ≥ 12 and no coagulation abnormalities on admission could have safely been admitted to our IMCU instead of the NSICU for further care and management. This would have led to a decrease in ICU admission rate. Application of such separate protocols for stroke IMCU admission vs ICU admission would lead to better utilization of resources at comprehensive stroke centers throughout the country.

scholarly journals The Impact of Left Ventricular Hypertrophy and Diastolic Dysfunction on Outcome in Intracerebral Hemorrhage Patients

ISRN Stroke ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Karen C. Albright ◽  
Joshua M. Burak ◽  
Tiffany R. Chang ◽  
Aimee Aysenne ◽  
James E. Siegler ◽  
...  
Keyword(s):  
Independent Predictor ◽  
International Normalized Ratio ◽  
Left Ventricular ◽  
Hematoma Expansion ◽  
Significant Independent Predictor ◽  
Term Outcome ◽  
Cross Sectional ◽  
Hemostatic Agents ◽  
Imaging Characteristics ◽  
The Impact

Background. The objective of this study was to determine the prevalence of LVH and DD in patients presenting with supratentorial deep ICH and to determine if the presence of LVH or DD was an independent predictor of initial ICH volume, hematoma expansion, or poor outcome. Methods. A cross-sectional study was performed on ICH patients who presented from 7/2008 to 12/2010. Cases were excluded if ICH was traumatic, lobar, infratentorial, secondary to elevated international normalized ratio, suspicious for underlying structural malformation, or where surgical evacuation was performed. Logistic and linear regressions were used to assess the ability of LVH to predict ICH imaging characteristics and patient outcomes. Results. After adjusting for use of hemostatic agents, LVH was not a significant independent predictor of initial ICH volume (P=0.344) or 33% volume expansion (P=0.378). After adjusting for age, infectious complications, and use of hemostatic agents, LVH was not a significant independent predictor of poor functional outcome (P=0.778). Similar results were seen for DD. Conclusion. In our sample, patients with deep ICH and LVH were more likely to develop IVH, but LVH was not a significant independent predictor of initial ICH volume, hematoma expansion, or poor short-term outcome.

Impact of 24/7/365 Attending Radiologist Coverage on the Turnaround Time in an Emergency and Trauma Radiology Department

2020 ◽  
pp. 084653711989932
Author(s):  
Sabeena Jalal ◽  
Hugue Ouellette ◽  
Zharmaine Ante ◽  
Peter Munk ◽  
Faisal Khosa ◽  
...  
Keyword(s):  
Chart Review ◽  
Emergency Radiology ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Turnaround Time ◽  
Radiology Department ◽  
Tertiary Care Center ◽  
Imaging Studies ◽  
The Impact

Objective: To study the impact of 24/7/365 attending radiologist coverage on the turnaround time (TAT) of trauma and nontrauma cases in an emergency and trauma radiology department. Patients and Methods: This was a retrospective chart review in which TAT of patients coming to the emergency department between 2 periods: (1) December 1, 2012, to September 30, 2013, and (2) January 1, 2017, to January 30, 2018, and whose reports were read by an attending emergency and trauma radiologist was noted. Results: The 24/7/365 radiology coverage was associated with a significant reduction in TAT of computed tomography reports, and the time reduction was comparable between trauma and nontrauma cases. In adjusted models, the extension of radiology coverage was associated with an average of 7.83 hours reduction in overall TAT (95% confidence interval [CI]: 7.44-8.22) for reports related to trauma, in which 2.73 hours were due to reduction in completion to transcription time (TC; 95% CI: 2.53-2.93), and 5.10 hours were due to reduction in transcription to finalization time (TF; 95% CI: 4.75-5.44). For reports related to nontrauma cases, 24/7/365 coverage was associated with an average of 6.07 hours reduction in overall TAT (95% CI: 3.54-8.59), 2.91 hours reduction in TC (95% CI: 1.55-4.26), and 3.16 hours reduction in TF (95% CI: 0.90-5.42). Conclusion: Our pilot study demonstrates that the implementation of on-site 24/7/365 attending emergency radiology coverage at a tertiary care center was associated with a reduced TAT for trauma and nontrauma patients imaging studies. Although the magnitude and precision of estimates were slightly higher for trauma cases as compared to nontrauma cases. Trauma examinations stand to benefit the most from 24/7/365 attending level radiology coverage.

Abstract TP341: Outcomes of Obese Patients With Intracerebral Hemorrhage

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Ifeanyi Iwuchukwu ◽  
Jessica A Ryder ◽  
Bethany Jennings ◽  
Philip Feliciano ◽  
Doan Nguyen ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Systolic Pressure ◽  
Obesity Paradox ◽  
Normal Weight ◽  
Hematoma Expansion ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Obese Patients ◽  
Poor Outcome ◽  
Imaging Characteristics

Introduction: Obesity is a known risk factor for cardiovascular disease and stroke. However, an obesity paradox - improved outcomes in obese patients, has been reported in coronary artery disease, cardiac surgery and ischemic stroke. We report a possible obesity paradox in patients with intracerebral hemorrhage (ICH). Methods: We retrospectively reviewed our prospectively collected database of patients diagnosed with ICH in our institution between November 2012 and March 2016. Trauma, malignancy, postoperative, vascular malformations associated hemorrhages and hemorrhagic conversion of ischemic strokes were excluded. Demographics, clinical, laboratory and imaging characteristics were collected. We defined obesity as body mass index (BMI) >30kg/m 2 ; overweight 25-29.9kg/m 2 ; normal weight 18.5-24.9kg/m 2 and underweight <18.5kg/m 2 . Poor outcome was defined by hematoma expansion >30% increase in ICH volume or discharge to nursing home, long-term acute facility or death (‘poor-discharge’). Continuous variables were analyzed using an analysis of variance and a fisher exact test or chi-square test for categorical variables. A p value <0.05 was set for significance. Results: 429 patients met criteria for our study. 50.1% were female, median age 64 years (SD 15.6) and BMI 27.4 (SD 7.9). There were 16 (3.7%) underweight; 131 (30.8%) normal weight; 138 (32.2%) overweight and 144 (33.6%) obese patients. Bivariate analysis across groups showed female gender (75% vs 56.5% vs 57% vs 50% p=0.015), diabetes mellitus (13.3% vs 20.6% vs 32.1% vs 33.3% p=0.041), systolic pressure (SBP) (177.5 vs 168 vs 175 vs 185 p=0.003), HbA1c (5.7 vs 5.9 vs 6.2 vs 6.5 p=0.0002), discharge poor outcome (43.8% vs 54.2% vs 55.8% vs 36.8% p=0.005) were significant. There was no difference in ICH volume and hematoma expansion. On multivariate analysis, only age (OR 1.02, CI 1.01 - 1.04 p=0.0004) SBP ≥ 140mmhg (OR 0.49, CI0.25 - 0.95, p=0.035) Admission glucose ≥180 (OR 2.71, CI 1.58 - 4.4.67 p=0.0003) and BMI >30kg/m 2 (OR 0.5, CI 0.29 - 0.87 p= 0.014) remained independent predictors of poor outcome. Conclusion: In our cohort, obese patients were more likely to have a good outcome suggesting the presence of an obesity paradox in outcome following intracerebral hemorrhage.

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