World Stroke Organization (WSO): Global intracerebral hemorrhage factsheet 2025.

Sheila O Martins, Rita Krishnamurthi, Ashkan Shoamanesh, Wendy C Ziai, Adrian R Parry-Jones, Craig S Anderson, Simiao Wu

Journal: International journal of stroke : official journal of the International Stroke Society 2025;20(2):145-150

PMID: 39629687

Abstract

BACKGROUND

Intracerebral hemorrhage (ICH) is stroke caused by non-traumatic bleeding into the brain.

AIM

This factsheet provides summary statistics for ICH from the 2021 Global of Burden of Diseases Study.

METHODS

Data were downloaded from the GBD results platform using "intracerebral hemorrhage" as a Level 4 cause of death or injury, extracting key metrics (number, percent, rate) for measures (incidence, disabilty adjusted life years [DALYs], deaths) described in this factsheet.

RESULTS

Globally, stroke was the third leading cause of death in 2021, and ICH accounted for 28.8% of incident strokes. There were estimated to be 7,252,678 deaths due to stroke in 2021 of which ICH accounted for 3,308,367 (45.6%). When considering the burden of ICH in terms of DALYs, ICH accounts for nearly half of the burden of stroke at 49.5%, compared to 43.8% caused by ischemic stroke. ICH must therefore be considered on an equal footing with ischemic stroke, so that efforts can be made to reduce its burden through public health, research, and healthcare provision. Although the overall age-standardized incidence of ICH has been decreasing since 1990, the rate of reduction has been much slower in regions with lower socio-demographic index (SDI). Most of the burden of ICH lies in areas with lower SDI, with 94.2% of DALYs lost to ICH outside areas of high SDI. Geographically, the majority of DALYs due to ICH occur in Southeast Asia, East Asia, and Oceania, with 53.3% of global DALYs lost in these regions alone. The risk factors for ICH are dominated by high systolic blood pressure, which accounts for at least 50% of the burden of ICH, regardless of SDI. Areas with middle or high-middle SDI have a greater proportion of the burden of ICH accounted for by ambient particulate pollution, smoking, and diets high in sodium, whereas household air pollution from solid fuels accounts for much more of the risk of ICH in low SDI regions.

CONCLUSION

This World Stroke Organization (WSO) Global ICH Fact Sheet 2025 provides the most updated information on ICH that can be used to support communication with all internal and external stakeholders, inform healthcare policy, and raise public awareness. All statistics have been reviewed and approved for use by the WSO Executive Committee.

Address: Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance and University of Manchester, Manchester, UK.; Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.; National Institute of Stroke and Applied Neurosciences, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.; Departments of Neurology, Neurosurgery and Anaesthesiology/Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Department of Medicine (Neurology), McMaster University and Population Health Research Institute, Hamilton, ON, Canada.; Department of Neurology, West China Hospital, Sichuan University, Chengdu, P.R. China.; Centre for Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu, P.R. China.; Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Neurology Service, Hospital Moinhos de Vento, Porto Alegre, Brazil.; Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.; The George Institute for Global Health, Sydney, NSW, Australia.
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