Leukocytes and primary intracerebral hemorrhage

Introduction and objective:The association between the leucocyte count and prognosis observed in ischemic cerebrovascular disease and subarachnoid hemorrhage has rarely been reported in primary intracerebral hemorrhage. The objective of our study is to assess the importance of the number of leukocytes in the peripheral blood during the first 24 hours for prognosis of mortality.

Patients and methods:We made a prospective analysis of supratentorial primary intracerebral hemorrhages seen during the first 24 hours during the period 1987-1994. We evaluated the relationship between age, sex, size of hematoma, blood found in the ventricles, level of consciousness on admission, survival and prognosis after 30 days, level of glucaemia, arterial hypertension and leucocyte count.

Results:We considered 186 primary intracerebral hemorrhages (64% men and 36% women); the average age was 64 years (Standard Deviation: 10 years). There were 63% deep and 37% lobar hemorrhages. Thirty five percent of the patients died. Leucocytosis was associated with survival (p = 0.003), prognosis (p = 0.0005) and intraventricular bleeding (p = 0.03). We found a significant relationship between the size of the hematoma (r = 0.256; df = 186; p < 0.0001), level of glycaemia on admission (r = 0.282; df = 186; p < 0.0001), level of consciousness (r = -0.263; df = 186, p < 0.0001) and leukocyte count.

Conclusions:The peripheral blood leucocyte count was significantly associated with prognosis and increased mortality. It may therefore be considered to be another parameter of bad prognosis in primary intracerebral hemorrhage.