Background/Objectives: Spontaneous intracerebral hemorrhage (sICH) is a particularly severe subtype of stroke, characterized by high rates of mortality and long-term disability, for which robust prognostic markers are still lacking. The aim of this study was to assess the relationship of the ICH score, the National Institutes of Health Stroke Scale (NIHSS) score, and serum high-sensitivity cardiac troponin I (hs-cTnI) levels with 30-day mortality in patients with sICH. Methods: We conducted a prospective observational cohort study enrolling 100 consecutive patients diagnosed with sICH based on neuroimaging findings. Demographic data, clinical parameters, neuroimaging findings, and serum hs-cTnI levels were collected on admission. Subsequently, the ICH score, its individual components, and the NIHSS score were assessed. Results: Patients who died were older and had significantly higher ICH and NIHSS scores, lower Glasgow Coma Scale (GCS) scores, larger hematoma volumes, more frequent intraventricular hemorrhage (IVH), and elevated hs-cTnI levels compared to survivors. Serum hs-cTnI concentrations were significantly correlated with ICH and NIHSS scores, lower GCS scores, larger hematoma volumes, and the presence of IVH. On univariate logistic regression, higher ICH score, NIHSS score, and hs-cTnI level were associated with mortality, whereas multivariate analysis identified the GCS score, hematoma volume, and IVH score as significant independent factors related to fatal outcome. Conclusions: Individual components of the ICH score may provide useful information on outcomes in patients with sICH. Higher serum hs-cTnI levels were associated with 30-day mortality but were not independent predictors. These markers may assist in patient monitoring and support established clinical procedures in therapeutic decision-making. Nevertheless, larger multicenter studies are needed to further clarify their clinical implications in sICH management.

Background/Objectives: Spontaneous intracerebral hemorrhage (sICH) is a severe form of stroke associated with high mortality and disability rates, and reliable prognostic markers remain limited. This study aimed to evaluate the prognostic value of ICH score components, the National Institutes of Health Stroke Scale (NIHSS), and high-sensitivity cardiac troponin I (hs-cTnI) for predicting 30-day mortality in patients with sICH. Methods: In this prospective observational cohort study, 100 consecutive patients with neuroradiologically confirmed sICH were enrolled. Demographic data, clinical parameters, neuroimaging findings, and serum hs-cTnI levels were collected on admission. Subsequently, the ICH score, its individual components, and the NIHSS score were assessed. Results: Patients who died had significantly higher ICH and NIHSS scores, were older, had lower Glasgow Coma Scale (GCS) scores, larger hema-toma volumes, more frequent intraventricular hemorrhage (IVH), and elevated hs-cTnI levels compared with survivors. Serum hs-cTnI concentrations significantly correlated with ICH and NIHSS scores, lower GCS scores, larger hematoma volumes, and the presence of IVH. On univariate logistic regression, ICH score, NIHSS, and hs-cTnI were independent predictors of mortality, whereas multivariate analysis identified GCS score, hematoma volume, and IVH as significant determinants of fatal outcome. Conclusions: ICH score and its components, NIHSS, and serum hs-cTnI levels are valuable prognostic tools in patients with sICH. These markers may help clinicians identify high-risk pa-tients, optimize monitoring, and guide therapeutic decisions. Nevertheless, larger multicenter studies are warranted to further clarify their clinical implications in sICH management.