2026 American Academy of Neurology Abstract Website

Objective:

To estimate the proportion of cases deteriorating at 72 hours after ICH as studied by Glassgow coma scale.

Background:

Hypertension is the most common risk factor for spontaneous intracerebral haemorrhage (ICH), contributing substantially to morbidity and mortality. Hematoma expansion, defined as an increase of >6 ml on serial CT imaging, has been associated with poor neurological outcomes. This study was conducted to evaluate early neurological deterioration (END) at 72 hours using the Glasgow Coma Scale (GCS) in patients with spontaneous ICH.

Design/Methods:

A total of 128 patients with hypertensive ICH were included in this prospective observational study. GCS, ICH scores, and hematoma volumes (calculated using the ABC/2 method) were recorded at admission, 24 hours, and 72 hours. Early neurological deterioration was defined as a fall of ≥2 points in GCS at 72 hours. The study examined associations among hematoma volume, antihypertensive therapy, GCS trends, and mortality.

Results:

The mean age was 55.34 ± 12.72 years, with 70.3% male participants. END occurred in 46.3% of patients by 72 hours. Hematoma volume showed a significant negative correlation with GCS at 72 hours (r = -0.365, p < 0.001). Increased antihypertensive requirements correlated significantly with larger hematoma volumes (p = 0.015). Overall mortality was 53.1%, with most deaths occurring within 72 hours.

Conclusions:

Nearly half of the ICH patients experienced early neurological deterioration within 72 hours, with hematoma expansion and high ICH scores as strong contributors. Close monitoring of GCS, blood pressure, and hematoma volume in the initial 72-hour window is essential to mitigate early deterioration and guide critical interventions.