For individuals with intracerebral hemorrhage (ICH), the reported 30-day survival rate ranges from 40% to 70%; immediate functional prognosis with ICH is usually better than that with cerebral infarction because of differences in the amount of brain tissue damaged. The prognosis for individuals with lobar hematomas is usually better than that for individuals with other forms of ICHs. The overall mortality rate is approximately 15% to 30%; approximately 50% of survivors have full functional recovery. Predictors of poor outcome after lobar hemorrhage include hemorrhage of more than 40 mL, intraventricular extension of the hemorrhage, and degree of midline shift. The outcome of caudate hemorrhage is usually relatively benign, and patients typically have full recovery without permanent neurologic deficit. Even with intraventricular extension, which is common, the short-term prognosis is still relatively good.

For individuals with putaminal hemorrhage, the mortality rate is approximately 40%, although the range of clinical presentations is marked and typically depends on the volume of hemorrhage. Progressive neurologic deficit with hemiplegia and coma at admission correlate with poor functional outcome among survivors, whereas a normal level of consciousness, normal extraocular movements, and partial hemiparesis portend a better functional level among survivors. Radiologic imaging characteristics that are predictive of a poor prognosis include large hemorrhage size and intraventricular extension.

The outlook for functional status for patients with thalamic hemorrhage is usually poor, directly depending on the size of the lesion; hemorrhages that are more than 3 cm in diameter are almost always fatal. Intraventricular extension is common in thalamic hemorrhage but is not necessarily associated with a poor prognosis unless hydrocephalus occurs. The level of consciousness at presentation is also a good predictor of survival.

In brainstem hemorrhage, death usually occurs within a few hours, but, occasionally, patients with a small hemorrhagic lesion may survive, with functional level dependent on the site and size of the hemorrhage and on the severity of symptoms at onset.

The clinical course in cerebellar hemorrhage is unpredictable; as hours pass, some patients who are alert or drowsy on admission can suddenly become stuporous and then comatose as a result of progressive brainstem compression, whereas others with a similar clinical status at admission have complete functional recovery (vermis hemorrhage is associated with relatively poor survival rates). Patients who have progression have a much better prognosis with surgery if they are still arousable when taken to the operating room than do patients who are in coma. Computed tomography (CT) or magnetic resonance imaging (MRI) findings indicate that hydrocephalus, intraventricular hemorrhage, and
hemorrhage of 3 cm or more are also associated with a poor prognosis. Overall, survivors of cerebellar hemorrhage typically have a good functional prognosis.