Advancements in predicting clinical factors for hematoma enlargement in primary cerebral hemorrhage patients: a review.

Abstract

Background: Spontaneous intracerebral hemorrhage (sICH) is a devastating form of stroke with high mortality and disability rates. Hematoma expansion (HE) occurs in over 30% of sICH patients and serves as a critical predictor of poor outcomes. This review aims to synthesize current evidence on clinical factors predicting HE in sICH patients.

Methods: We conducted a comprehensive literature search of major databases from inception to December 2024. Included studies examined clinical, radiological, and biochemical factors associated with HE in sICH.

Results: Multiple factors demonstrate predictive value for HE, including hematoma volume, irregular shape, ultra-early growth rate, coagulation status, blood pressure parameters, and specific imaging markers. Emerging technologies including advanced MRI and biomarker assays show promise for improved prediction. Multimodal prediction models incorporating clinical and imaging data demonstrate superior predictive accuracy compared to single parameters.

Conclusion: Early identification of HE risks factors enables targeted intervention and may improve clinical outcomes. Future research should focus on validating multimodal prediction tools and developing targeted therapies for high-risk patients.