| Impact of Intraventricular Hemorrhage upon Intracerebral Hematoma Expansion. | |
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MedLine Citation:
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PMID: 20882367 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this study is to determine whether intraventricular hemorrhage (IVH) exerts a "decompressive" effect that limits intracerebral hemorrhage (ICH) enlargement. METHODS: Retrospective review of patients with spontaneous supratentorial ICH diagnosed within 6 h of onset, who underwent follow-up head CT approximately 48 h later. Digital imaging analysis of CT scans was performed to compare hematoma volume changes between patients with and without IVH. Hemorrhage locations were classified as paraventricular (PV) or non-PV. Regression analyses were employed to identify predictors of IVH, hematoma expansion, and mortality. RESULTS: Of the 70 patients included 57% developed IVH, 85% of which occurred before initial CT. 71% of PV hemorrhages developed IVH, all before initial CT, and 48% of non-PV hemorrhages developed IVH, 29% of which occurred after initial CT. IVH was associated with PV location (P = 0.04), and among IVH patients PV location was associated with early IVH (P = 0.003). Predictors of mortality included age (P = 0.037), initial hematoma volume (P < 0.04), absolute volume change (P = 0.01), and final hematoma volume (P < 0.001). Variables predicting IVH included PV location (P < 0.0001), larger initial hematoma volume (P = 0.002), and greater absolute volume increase (P = 0.01). Hematoma expansion was greatest for non-PV with IVH (P = 0.08), and graphic inspection suggested that ICH volume tended to decrease with PV location and increase with IVH. Final hematoma volume was associated with initial volume (P < 0.0001), non-PV location (P = 0.02), and IVH (P = 0.04). CONCLUSIONS: IVH was not associated with less hematoma volume expansion, and for non-PV hemorrhages IVH was linked to greater volume increase. |
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Authors:
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Michael Moussouttas; Rishi Malhotra; Luis Fernandez; Mitchell Maltenfort; Melissa Holowecki; Jennifer Delgado; Nadine Lawson; Neeraj Badjatia |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurocritical care Volume: 14 ISSN: 1556-0961 ISO Abbreviation: Neurocrit Care Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101156086 Medline TA: Neurocrit Care Country: United States |
Other Details:
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Languages: eng Pagination: 50-4 Citation Subset: IM |
Affiliation:
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Division of Cerebrovascular and Neurocritical Care, Thomas Jefferson Medical Center, 900 Walnut Street, Suite 200, Philadelphia, PA, 19107, USA, arista1@pol.net. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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