The Role of Age in Intracerebral Hemorrhage: An Intricate Relationship

Strokes are one of the leading causes of death in the United States, and intracerebral hemorrhage is the deadliest type of stroke. Age is a strong risk factor for intracerebral hemorrhages and it also affects the body in numerous ways?including changes to the cardiovascular and central nervous systems? that interplay with multiple risk factors. Understanding the role of age in risk and outcomes can guide treatment and future clinical trials. We reviewed the literature for intracerebral hemorrhage risk factors. This review aimed to identify the role of age, as well as characterize the most commonly used age cut-off points in the literature. Current review of the literature suggests the age cut-off for mortality and morbidity vary between 60-80 years of age, with the most common values of 65 or 70 years. In addition to age as a determinant of outcomes, it increases the risk of multiple chronic health conditions and comorbidities including hypertension, diabetes, and treatment with anticoagulants which contribute to the pathology of intracerebral hemorrhages. The interaction of these chronic conditions, age, and intracerebral hemorrhage is evident; however, the exact mechanism and extent of impact remain unclear. The ambiguity of these connections may be further obscured by the current recommendations, individual patient preferences, and literature supported trials of treatment options for aging patients.