Spontaneous Intracerebral Hemorrhage: Clinical Profile And Natural History In A Sub-Saharan Africa Country: A Prospective And Multicentric Cohort Study

Background: Stroke is a very common disease and well studied in high-income countries being predominantly ischemic and in elderly patients. In African low-income countries there is initial evidence of Youngers patients and hemorrhagic strokes with a worse neurological outcome. We aimed to analyze the clinical profile and natural history of patients with spontaneous intracerebral hemorrhage in 3 main tertiary Hospitals in Luanda – Angola. Methods: Prospective multicentric cohort study, In the 3 main tertiary Hospitals in Luanda, capital of Angola. We prospectively included all patients with stroke from During a Year and analyzed only those with spontaneous intracerebral hemorrhage (SIH). The follow up time was 90 days with neurological outcome evaluation using modified Rankin scale on 30, 60 and 90 days of follow up, survival analysis was performed using Kaplan Meier curve, exclusion criteria were traumatic lesion, Subarachnoid hemorrhage, brain tumor and pediatric age. Findings: On final analysis 150 patients were included, 54% were female, mean age 51 years old, main risk factor was arterial hypertension, main symptom was motor weakness, mean time of hospitalization was 14 days. On a 30 days analysis mortality rate was 29% on discharge, overall mortality was 55%, and functionally independent patients were only 29%. There are not surgical patients in this study because in public health system in Angola, surgical treatment for hemorrhagic stroke is not performed, so this is the natural history of this disease in Angola Interpretation: SIH is an important cause of mortality in Angola (sub-Saharan Africa), with worse results because patients who would be candidates are not operated on. Adequate blood pressure control and implementation of surgery for selected cases could change the natural history. Keywords : Stroke; intracerebral Hemorrhage; Angola; Global Neurosurgery