Nontraumatic intracerebral haemorrhage (ICH) is a common subtype of stroke with a poor prognosis, high mortality and long-term morbidity. The incidence of ICH increases with age. ICH has not been widely investigated in young adults (herein defined as aged ∼18–50 years) despite an annual incidence of ∼5 per 100,000 individuals. Furthermore, ICH characteristics differ between young and elderly patients. Risk factors for ICH are surprisingly common in young adults, in whom ICH is often caused by structural lesions or hypertension, and only rarely by anticoagulation therapy and cerebral amyloid angiopathy (which are common predisposing factors in elderly patients). High short-term mortality (17% at 3 months) and long-term mortality (>25% at 10 years) persist even in contemporary series from high-income countries, and long-term disability is very common. Thus, an aggressive approach to identifying treatable underlying conditions and preventing ICH recurrence is indicated in young patients, although treatment strategies have generally not been investigated specifically in this age group. This narrative Review summarizes existing knowledge on the epidemiology, risk factors, causes, diagnosis, treatment and outcomes of ICH in young adults. We provide comparisons with the population of elderly patients with ICH and discuss challenges for future research.

非创伤性脑出血（ICH）是中风的常见亚型，预后差，死亡率高且长期发病。ICH的发病率随年龄增长而增加。尽管年发病率为〜，但尚未在青年（定义为18至50岁）中对ICH进行广泛的研究。每100,000个人中有5个人。此外，年轻患者和老年患者的ICH特征也不同。ICH的危险因素在年轻人中出奇地普遍，其中ICH通常由结构性病变或高血压引起，而很少由抗凝治疗和脑淀粉样血管病（这是老年患者的常见诱发因素）引起。即使在来自高收入国家的当代研究中，高短期死亡率（3个月时为17％）和长期死亡率（10年时为> 25％）仍然存在，长期残疾非常普遍。因此，尽管在这一年龄组中尚未专门研究治疗策略，但在年轻患者中指出了一种积极的方法来确定可治疗的基础疾病并预防ICH复发。这篇叙述性综述总结了有关年轻成人ICH的流行病学，危险因素，病因，诊断，治疗和结局的现有知识。我们提供与ICH老年患者人群的比较，并讨论未来研究的挑战。