Background: Spontaneous intracerebral hemorrhage (SICH) is a significant cause of stroke, with high mortality and morbidity rates. This study evaluates the influence of hematoma volume, anatomical location, and initial Glasgow Coma Scale (GCS) score on 30-day outcomes in SICH patients.

Methods: A prospective single-center study was conducted at Government Vellore Medical College Hospital, including 50 patients aged over 18 years with SICH confirmed by non-contrast CT brain imaging. Exclusion criteria included traumatic hemorrhage, subarachnoid hemorrhage, and secondary hemorrhages due to tumors or vascular malformations. Variables analyzed included demographic data, clinical features, GCS on admission, radiological findings, and in-hospital outcomes. Hematoma volume, anatomical location, and treatment modalities were correlated with mortality and morbidity.

Results: Of the 50 patients, 42% died within 30 days. Infratentorial hemorrhages were associated with the highest mortality (53.8%, p=0.04). Mean hematoma volume was 12.25 mL (SD 14.53) in deceased patients and 18.9 mL (SD 12.14) in survivors (p=0.38). Patients with intraventricular hemorrhage (IVH) had a 68.8% mortality rate. Surgical intervention (decompressive craniectomy or external ventricular drain) was performed in 86% of cases, with 51.2% survival.

Conclusion: Infratentorial location and IVH were significant predictors of poor outcome, while hematoma volume showed no statistically significant correlation with mortality.