Correlation of Variation in Weather Conditions and Non-Traumatic Intracerebral Hemorrhage (NTICH)

IntroductionNon-traumatic intracerebral hemorrhage (NTICH) indicate bleeding within the brain parenchyma due to loss of integrity of cranial vessel without any external 1 cause or trauma.It has an annual incidence of 24.6 per 100,000 individuals, it is a serious condition with 2 high mortality and morbidity and poor prognosis.It leads to permanent disability including cognitive impairment, mental and emotional disorders along other 3 symptoms.The estimated global annual incident of intracerebral hemorrhage (ICH) 29.9 per 100000 per 4 year.Asians have the highest incident of ICH than any 5 other population with 51.8 per 100000 person per year.As compared to ischemic stroke, mortality and morbidity 6 associated with ICH is high.There are several risk factors of NTICH such as hypertension, aneurysm, altered hemostasis, cerebral amyloid angiopathy, hemorrhagic necrosis due to neoplasm or infection, hypocholestero-lemia, chronic kidney disease and cerebral microbleeds, smoking, excessive alcohol consumption, drugs use, 7,8old age, male sex, Asian ethnicity.Simultaneous variations in meteorological conditions leads to several weather changes such as humidity, temperature, and air pressure.These changes in turn have known to influence various human body health conditions including cardiovascular events, respiratory diseases are influence by it.In recent decade research have indicate that there might be a relationship between intracerebral hemorr-9, 10, 11 hage and changes in weather conditions.NTICH association with weather has been discussed in literature, studies have showed association of seasonal 7,9-11 pattern with incidence of NTICH.Higher number of cases reported during winters, with a positive asso-12 ciation with colder temperature.Various different plausible explanation has been described in studies for this association from lower temperature, blood vis- AbstractObjective: To assess the correlation of non-traumatic intracerebral hemorrhage with variation in weather conditions in Sialkot.Methods: A cross-sectional survey was conducted, 178 patients that reported with intracerebral hemorrhage at the emergency department were included in this study.After the diagnostic confirmation through imaging studies patients' demographic information, month of ICH was recorded.Weather pattern (low, high, and average temperature) corresponding to the incidence of ICH were also recorded.The frequency of NTICH was calculated by measuring the NTICH event reported at the study setting during each month of the year.The relationship between NTICH frequency with seasonal variations and the risk factors was measured using Pearson correlation at p 0.05 level of significance.Results: Statistically strong relation was found between the number of NTICH cases reported with the variation in average temperature corresponding month (p=0.01) as well as the seasonal variation (p=0.01).Similarly, strong positive relation of hypertension with frequency of NTICH cases (p=0.01). Conclusion:There is increased risk of non-traumatic intracerebral hemorrhage during winter months, especially with ambient temperature around less than 10C.This risk specifically high in patients with known comorbidity of hypertension.