Incidence of progression or rebleeding in hypertensive intracerebral hemorrhage

The incidence of progression or rebleeding in hypertensive intracerebral hemorrhage (HICH) has not been clearly established. We review 56 cases of HICH involving the basal ganglia or thalamus and found four cases (one thalamic, three basal ganglia) in which progression or rebleeding occurred. These cases represent 7% (4/56) of the total number of cases and 13.8% (4/29) of the cases in which serial computer tomography (CT) was performed. In two cases, progression or rebleeding occurred during the first 24 h after onset of symptoms, whereas in the other two cases rebleeding appeared to be delayed (CT changes noted 5 and 6 days later). This study suggests that the incidence of progression or rebleeding in HICH occurs more commonly than had been believed and that rebleeding may occur early or late