Clinical characteristics and outcome of intracerebral hemorrhage in young adults Loes CA Rutten-JacobsNoortje AM MaaijweeRenate M. Arntz • Hennie C. SchoonderwaldtLucille D. DorresteijnEwoud J. van Dijk •

Data on determinants of prognosis after intra- cerebral hemorrhage (ICH) in young adults are scarce. Our aim was to identify clinical determinants of prognosis after ICH in adults aged 18-50. We investigated 98 consecutive patients with an ICH, aged 18-50 years, admitted to our hospital between 1980 and 2010. Collected ICH charac- teristics included presenting symptoms, etiology, location, severity and Glasgow Coma Scale (GCS). Outcomes were case-fatality (death within 30 days), poor functional out- come (modified Rankin Scale(2), long-term mortality and recurrent ICH. We assessed discriminatory power of fac- tors associated with case-fatality (area under receiver operating curve (AUC)). Case-fatality was 20.4 % (n = 20) and well predicted by the GCS (AUC 0.83). Among 30-day survivors, a poor functional outcome at discharge was present in 51.3 %. During a mean follow-up of 11.3 years mortality was only increased in patients aged 40-50 years (standardized mortality ratio 4.8 (95 % CI 2.3-8.6)), but not in patients aged 18-40 years. Recurrent ICH occurred in 6 patients (10-year cumulative incidence 12.2 % (95 % CI 1.5-22.9 %)), all with the index ICH attributable to structural vascular malformations. Prognosis after ICH in young adults is poor, mainly due to high case- fatality, that is well predicted by the GCS. An exception is 30-day survivors \40 years, who have a similar risk of dying as the general population. Recurrence risk is espe- cially present in patients with structural vascular malfor- mations, whereas risk seems to be very low in other patients.