The Contribution of Nonaneurysmal Intracranial Hemorrhage to Stroke Mortality in New York City Blacks

Abstract

Of 527 unselected stroke patients (98% black) in a city hospital, 80 (17%) had nonaneurysmal intracranial hemorrhages, with a fatality rate of 85%. Of 216 inhospital deaths 37% were due to such hemorrhages. In patients aged 65 and less, 52% of 90 fatal events were hemorrhagic. Only in patients below age 46, however, did cerebral hemorrhage account for more deaths than infarction. The incidence of hemorrhage and the proportion of inhospital deaths from it were higher than in three white American and lower than in one black African series. The differences were not major, and could be explained by varying definitions and hospital use. The mean age of patients with fatal hemorrhage was 61 years. When the inhospital mortality is extrapolated into annual mortality estimates, the following conclusions may be drawn about spontaneous nonaneurysmal intracranial hemorrhage in New York City blacks: (1) above age 45, it does not account for more deaths than infarction, (2) it is not much more common or more lethal in blacks than in whites, and (3) it does not occur more predominantly at earlier ages in blacks than in whites.