Background: Intracerebral hemorrhage (ICH) often results in significant neurological impairments, necessitating effective tools for prognosis and rehabilitation monitoring. Somatosensory evoked potentials (SSEPs), particularly the N20 and P40 responses, offer a noninvasive and reproducible method to assess sensory pathway integrity and functional outcomes in stroke patients. Objective: This study aimed to investigate the relationship between clinical status, computed tomography (CT) imaging, and SSEP findings in patients with first-time localized ICH, emphasizing the role of both median and tibial nerve stimulation in monitoring functional recovery. Methods: A prospective observational study was conducted over a period of one year at a tertiary care teaching hospital in Rajasthan. A total of 48 adult patients (≥18 years) presenting with a first-ever, localized, nontraumatic ICH were enrolled. All patients underwent detailed clinical assessments using the Modified Rankin Scale (mRS) for functional disability. Non-contrast CT (NCCT) of the brain and bilateral SSEPs (median and tibial nerve stimulation) were performed within 72 hours of symptom onset and repeated after 7 days. SSEP parameters, including peak latencies (N20 for median, P40 for tibial), and amplitudes were recorded and analyzed. Associations between clinical scores, CT findings (location and size of hemorrhage), and SSEP changes were statistically evaluated. Results: Most patients were male (58.3%) and over 60 years of age (81.3%), with thalamic (45.8%) and putaminal (33.3%) hemorrhages being most common. SSEPs showed increased latencies over time, especially in the right tibial nerve, while amplitudes remained stable.No significant association was found between hemorrhagic location and MRS score. Strong correlations were observed between SSEP amplitudes at both time points (r > 0.94, p < 0.001), while latency correlations were weak. Conclusion: SSEPs provide an objective measure of sensory pathway integrity and are particularly useful for monitoring early neurophysiological changes following ICH. SSEPs are valuable prognostic tools in ICH, providing insight into neural recovery beyond what CT imaging alone can offer. Their stability and responsiveness to functional changes support their integration into stroke rehabilitation protocols.

Intracerebral hemorrhage, somatosensory evoked potentials, median nerve, tibial nerve, CT imaging, N20, P40.