Epidemiological studies indicate a higher incidence of intracerebral hemorrhage among persons with low total serum cholesterol level.
To examine the prospective relationship of total serum cholesterol with a subsequent intracerebral hemorrhage in an Iraqi population sample.
PATIENTS AND METHODS:
A case-control study was performed to assess the relationship between spontaneous intracerebral hemorrhage (ICH) and low serum cholesterol. Eighty patients were admitted, from April 2007 to April 2008, to both Baghdad Teaching Hospital and Sulaimaniyah General Teaching Hospital with a diagnosis of spontaneous ICH. All the patients aged 50 or more years. After the initial review for exclusion criteria, 62 patients were enrolled. The other patients were excluded because of secondary causes of hemorrhages. Brain CT scan was done at the radiology department of both hospitals and read by radiologists. Fasting serum lipid profile was evaluated by the laboratory staff of the hospitals.
It was noticed that the cholesterol values fall acutely after hemorrhage. Mean total cholesterol was significantly lower within 48 h (total cholesterol 1TC1) and 1-2 weeks (total cholesterol 2TC2) than in 3 months (total cholesterol 3TC3), following hemorrhage. In addition, no significant change between TC1 and TC2 groups was noticed, though TC1 values proved to be somewhat higher. A significantly increased proportion (42%) of hemorrhage cases had TC3 values that were in the sex specific lowest quintile of the control group (20%). Dividing the cases according to likely etiology demonstrated similar overrepresentations within the hypertensive and non-hypertensive subgroups.
Our data in patients with proved spontaneous ICH confirm the population based observation that individuals with the lowest cholesterol levels are at increased risk of ICH.