Emilson Charles Rasolonjatovo¹*, Radotina Tony Andrianaivo¹, Tsiky Ketsia Rakotovao¹, Lantoariliva Rajohnson¹, Willy Ratovondrainy², Mamiarisoa Rabarijaona¹ and Clément Andriamamonjy¹

¹Department of Neurosurgery, Hospital University Center of Joseph Ravoahangy, Andrianavalona, Antananarivo, Madagascar
²Department of Neurosurgery, Hospital Center Soavindriana, Antananarivo, Madagascar

*Corresponding Author: Emilson Charles Rasolonjatovo, Department of Neurosurgery, Hospital University Center of Joseph Ravoahangy, Andrianavalona, Antananarivo, Madagascar.

Received: May 11, 2026; Published: May 31, 2026

Abstract

Stroke is the second leading cause of death worldwide. Early management remains a major challenge, and understanding prognostic factors is essential for optimizing therapeutic strategies. The objective of this study was to determine the prognostic factors associated with short-term mortality in surgically managed hemorrhagic stroke patients.

Method and Result: This retrospective analytical study was conducted at the University Hospital Joseph Ravoahangy Andrianavalona in Antananarivo, Madagascar. The study covered a two-year period from January 2022 to January 2024. All surgically managed hemorrhagic stroke cases were included. The Hemphill Intracerebral Hemorrhage Score (ICH score) was used for clinical and prognostic evaluation. Statistical analysis included Pearson’s Chi-square test for comparison of proportions and Student’s t-test for comparison of means. Odds ratios (OR) with 95% confidence intervals (CI) were calculated with a significance threshold set at p < 0.05.

Poor prognostic factors identified were: systolic blood pressure greater than 140 mmHg on admission (4.38-fold increase; p < 0.05), the association of three modifiable risk factors including obesity, alcohol consumption, and smoking (OR 2.5 [1.03-6.6]; p < 0.05), posterior fossa hematoma location (OR 4; 95% CI 1.02-18.15; p < 0.05), hematoma volume greater than 80 ml (OR 3.3 [1.14-9.8]; p < 0.05), low Glasgow Coma Scale score (OR 12.6 [3.7-42.8]; p < 0.05), and an ICH score equal to 4 (OR 9; 95% CI 1.01-94.9). The overall mortality rate in this study was 50.8%. A significant association between delayed management and mortality was found in patients operated on after more than 72 hours (OR 4.3; 95% CI 1.02-18.8).

Conclusion: The short-term prognosis of hemorrhagic stroke remains poor in our setting. Early identification and appropriate management of modifiable risk factors, particularly hypertension, remain essential preventive strategies. Surgical management within the first twenty-four hours appears to significantly improve patient outcomes.

Keywords: Hemorrhagic Stroke; Arterial Hypertension; Surgery; Prognosis

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Citation

Citation: Emilson Charles Rasolonjatovo., et al. “Hemorrhagic Stroke: Prognostic Factors for Mortality in Operated Cases". Acta Scientific Neurology 9.6 (2026): 24-30.

Copyright

Copyright: ©2026 Emilson Charles Rasolonjatovo., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.