Abstract Background and aims Intracerebral haemorrhage (ICH) is associated with high mortality and disability. Understanding real-world patterns of ICH incidence, severity, and in-hospital management is essential for identifying gaps in care, particularly in regions with evolving stroke systems. The aim was to access the incidence, clinical severity, and in-hospital management characteristics of ICH over one calendar year using national stroke registry data from a tertiary stroke center. Methods A retrospective analysis of prospectively collected registry data, including all consecutive ICH admissions between 1 January and 31 December 2025 was performed. Quarterly analyses (Q1-Q4) evaluated ICH case volume, proportion among all stroke admissions, severity (ICH score), baseline hematoma volume, acute management indicators, and surgical intervention. Completeness of guideline-recommended ICH process metrics was also examined. Results Among 175 total stroke admissions, 21 patients (12%) were diagnosed with ICH. The proportion of ICH varied across quarters, ranging from 11% to 21% of all stroke cases. Median ICH score ranged from 0 to 1, indicating predominantly mild-to-moderate hemorrhage severity. Mean baseline hematoma volume showed substantial variability across reporting quarters (5-34 ml). No minimally invasive hematoma evacuations were performed during the study period, and hematoma expansion metrics were not documented. Registry capture of acute ICH management indicators, including blood pressure target achievement and reversal timing, was limited. Conclusions This real-world registry analysis reveals variable ICH incidence with generally low-to-moderate severity, while highlighting important gaps in structured documentation of acute ICH management processes. Enhancing registry completeness and implementing standardized ICH care pathways may represent key opportunities to improve hemorrhagic stroke care. Conflict of interest Nothing to disclose
Anita Arsovska (Fri,) studied this question.