Clinical features and outcomes of intracerebral hemorrhage patients with dizziness: a multi-center cohort study.

BACKGROUND

Intracerebral hemorrhage (ICH) is the most serious type of stroke, and dizziness may be the sole presenting symptom of ICH. However, the prognosis of ICH patients presenting with dizziness remains unclear.

OBJECTIVES

This study aims to fill this gap by determining the prevalence of dizziness in patients with ICH, identifying the locations of associated hemorrhages, and evaluating its prognostic significance.

METHODS

We enrolled patients with ICH from two stroke centers between January 2016 and May 2024, collecting demographic, clinical, and imaging data. The 90-day modified Rankin Scale (mRS) distributions were used to evaluate clinical outcomes in ICH patients presenting with dizziness. Multivariable logistic regression analysis was performed to investigate correlation between dizziness and excellent outcome in ICH.

RESULTS

A total of 1718 patients who met the inclusion criteria were analyzed, including 165 ICH patients presenting with dizziness (9.6%). Multivariable logistic regression analysis demonstrated that, dizziness was an independent predictor of excellent outcomes at 90 days after adjusting for confounders in patients with ICH (adjusted OR, 2.118; 95% CI, 1.343-3.340; P = 0.001). The presence of infratentorial ICH, and intraventricular hemorrhage (IVH) on the baseline CT scan were significantly correlated with presence of dizziness (adjusted OR, 6.286; 95% CI, 4.237-9.324; P < 0.001; adjusted OR, 2.061; 95% CI, 1.382-3.071; P < 0.001, respectively).

CONCLUSION

Dizziness was not uncommon in patients with ICH and was an independent predictor of excellent functional outcomes at 90 days. Additionally, in ICH patients, dizziness was associated with infratentorial ICH and the presence of IVH on baseline CT imaging. These findings provide more evidence in risk stratification in ICH management.