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Abstract
Background:
Intracranial hemorrhage (ICH) is a lethal neurological disorder having high mortality and morbidity rate. Computed tomography is the modality of choice for the initial and immediate diagnosis of intracranial hemorrhage including the assessment of its types, sites, and severity. Age related changing significantly affect ICH the distribution, clinical signs, symptoms and causes as well. This study aims to compare the intracranial CT imaging characteristics and clinical features among the different age group such as children, adults and elderly patients.
Objective:
To evaluate and compare the CT imaging features of intracranial hemorrhage in children with those in adult and elderly populations to identify age-related diagnostic differences.
Methods:
A prospective, cross-sectional comparative study was conducted on 70 patients of intracranial hemorrhage. The Variables included patient age, gender, causes, types of ICH, location, fracture, midline shift (mm), GCS score and associated findings. Data collected through questionnaire, summarize and analyze with the help of Statistical Package of Social Sciences (SPSS version 26). Descriptive statistics, ANOVA and Pearson correlation tests applied to determine the relationships between different variables.
Results:
The predominant etiology of intracranial hemorrhage is trauma particularly in children and adult groups while non traumatic etiologies such as hypertension and microvascular cerebral amyloid angiopathy more common in elderly group. The types of ICH differently distributed among the different age groups such as extra axial types of ICH like subdural and epidural more common in adult patients whereas intraparenchymal hemorrhage more common in elderly patients. Statistically significant difference in midline shift among the different age groups F(35, 34) = 3.99, p < 0.001, which demonstrating that the radiological features shows severity with advance age and ICH type. Other than that also significant difference in GCS scores between different age groups (r = –0.876, p < 0.001) which means that GCS score lesser in elderly patients in comparison with other groups due to severe neurological deficit. Furthermore, negative correlation concluded between GCS and midline shift which demonstrating that the more severe the hemorrhage causes more mass effect which further result in lower GCS score or poor clinical outcomes. Overall the results emphasizing that computed tomography is the modality of choice for the diagnosing, classification and evaluation of prognosis in patients with intracranial hemorrhage. It also allow to compare the radiological characteristics with clinical outcomes which play crucial role in understanding the severity, management and outcomes in emergency situation.
Conclusion:
This study concluded that the age, etiologies and ICH types significantly influence the radiological characteristics and clinical features in patients presented with intracranial hemorrhage. Elderly patients showed the lower GCS score and severe midline shift which reflected the poor prognosis. The negative correlation between midline shift and GCS indicate the importance of radiological features and clinical presentations for evaluating the clinical outcomes and improving the management plans for patients present with ICH.