Intracerebral hemorrhage (ICH) is associated with high early mortality and poor long-term outcomes, making it one of the deadliest types of stroke.

• 30-day mortality: ~35–50%
  • Most deaths occur in the first 2 days, often due to hematoma expansion, herniation, or brainstem involvement.
• In-hospital mortality: ~20–30%, depending on hematoma volume, location, and patient comorbidities.
• Higher mortality seen in:
  • Brainstem and cerebellar hemorrhages
  • Large hematomas (>30–60 mL)
  • Intraventricular extension
  • Depressed level of consciousness at admission (GCS < 8)

• 1-year survival: ~35–40%
• Only 10–20% of survivors regain functional independence (modified Rankin Score ≤2).
• Risk of death remains elevated for months due to recurrent stroke, infections, and comorbid conditions.

• Age > 80 years
• Low Glasgow Coma Scale at presentation
• Large hematoma volume
• Infratentorial location
• Intraventricular hemorrhage
• High blood pressure on admission
• Lack of early surgical or ICU management when indicated

• ICH Score: validated clinical tool to estimate 30-day mortality based on:
  • GCS
  • Age
  • Hematoma volume
  • Intraventricular extension
  • Infratentorial origin

• Intracerebral hemorrhage definition
• ICH Score
• Intracerebral hemorrhage management

PM2.5 exposure—particularly household-related in low Socio-demographic Index regions—continues to drive significant intracerebral hemorrhage mortality and morbidity despite global reductions in age-standardized rates. Disparities persist, with low SDI areas experiencing a 24.7-fold higher ASMR than high SDI regions. Projections indicate a resurgence in PM2.5-related ICH burden by 2050, emphasizing the need for tailored public health interventions targeting APMP and HAP, especially in Asia and Sub-Saharan Africa ¹⁾