Objective: The objective of this article is to evaluate the clinical characteristics of spontaneous intracranial hemorrhages occurring in the post–COVID-19 (post-coronavirus disease 2019) period in patients without classical risk factors (hypertension, anticoagulant therapy, or vascular malformations) and to assess the concordance of these findings with the existing literature.
Materials and Methods: Between 2020 and 2024, 36 patients with a prior history of COVID-19 who presented with spontaneous intracerebral hemorrhage were retrospectively reviewed. Cases were evaluated for age, sex, Glasgow Coma Scale (GCS), international normalized ratio (INR), hemorrhage type and anatomical location, modified Rankin Scale (mRS), rebleeding, and overall clinical outcomes. Patients with any macroscopic vascular pathology were excluded from the study.
Results: The mean age of the patients was 52.0 years, and 61.1% were male. The overall mortality rate was 47.2%. Parenchymal hemorrhages comprised 55.6% of cases, subarachnoid hemorrhages 22.2%, and subdural hemorrhages 22.2%. Subarachnoid hemorrhages exhibited the highest mortality rate (87.5%). The mean Glasgow Coma Scale score was 8.2, and the mean modified Rankin Scale score at one year was 4.3. The GCS score was significantly associated with mortality (p=0.0001), whereas INR and age showed no significant relationship (p=0.2923 and p=0.6003, respectively).
Conclusion: In the post–COVID-19 period, intracerebral hemorrhages occurring in patients without classical etiological factors represent a notable clinical entity. The high mortality and rates of functional dependency observed indicate that this patient group requires novel strategies for early diagnosis and long-term monitoring.