Background and Purpose-We sought to determine plasma S 10013 level after acute (< 24 hours) spontaneous intracerebral hemorrhage (ICH) and to study its relation with neurological outcome. Methods-We determined S100B concentration on plasma samples from 78 ICH patients on admission. Clinical (Glasgow Coma Scale and National Institutes of Health Stroke Scale [NIHSS] scores) and radiological information (ICH and perihematomal edema volumes) were collected at baseline and follow-up visits. Early neurological deterioration, defined as the increase of >= 4 points in the NIHSS score at 48 hours, and unfavorable outcome (modified Rankin Scale > 2) at 3 months were also recorded. Results-The median S100B level was higher than our laboratory reference values for healthy controls (103.6 versus 48.5 mu g/mL; P < 0.001) and a positive correlation was observed between S100B level and baseline ICH volume (r=0.45; P < 0.0001). The median S100B level was higher in patients who deteriorated early (256.8 versus 89.7 pg/mL; P=0.001) and also in patients with an unfavorable outcome (136 versus 75.9 pg/mL; P=0.003). Multivariate analysis showed baseline ICH volume as the best predictor for both early neurological deterioration (odds ratio 15; 95% Cl, 2.9 to 76.3) and unfavorable outcome at 3 months (odds ratio 17; 95% CI, 2.0 to 142). Conclusion-Increased S100B level is found after acute spontaneous ICH, in association with a worse early and late evolution, and closely related to initial hematoma volume.