Document Detail


Intraventricular hemorrhage: Anatomic relationships and clinical implications.
MedLine Citation:
PMID:  18332342     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spontaneous intracerebral hemorrhage (ICH) is frequently associated with intraventricular hemorrhage (IVH), which is an independent predictor of poor outcome. The purpose of this study was to examine the relationship between ICH volume and anatomic location to IVH, and to determine if ICH decompression into the ventricle is truly beneficial. METHODS: We retrospectively analyzed the CT scans and charts of all patients with ICH admitted to our stroke center over a 3-year period. Outcome data were collected using our prospective stroke registry. RESULTS: We identified 406 patients with ICH. A total of 45% had IVH. Thalamic and caudate locations had the highest IVH frequency (69% and 100%). ICH volume and ICH location were predictors of IVH (p < 0.001). Within each location, decompression ranges (specific volume ranges where ventricular rupture tends to occur) were established. Patients with IVH were twice as likely to have a poor outcome (discharge modified Rankin scale of 4 to 6) (OR 2.25, p = 0.001) when compared to patients without IVH. Caudate location was associated with a good outcome despite 100% incidence of IVH. Spontaneous ventricular decompression was not associated with better outcome, regardless of parenchymal volume reduction (p = 0.72). CONCLUSIONS: Intraventricular hemorrhage (IVH) occurs in nearly half of patients with spontaneous intracerebral hemorrhage (ICH) and is related to ICH volume and location. IVH is likely to occur within the "decompression ranges" that take into account both ICH location and volume. Further, spontaneous ventricular decompression does not translate to better clinical outcome. This information may prove useful for future ICH trials, and to the clinician communicating with patients and families.
Authors:
H Hallevi; K C Albright; J Aronowski; A D Barreto; S Martin-Schild; A M Khaja; N R Gonzales; K Illoh; E A Noser; J C Grotta
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Neurology     Volume:  70     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-11     Completed Date:  2008-04-08     Revised Date:  2010-09-22    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  848-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, 6431 Fannin Street, MSB 7.044, Houston, TX 77030, USA. hen.hallevi@uth.tmc.edu
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MeSH Terms
Descriptor/Qualifier:
Cerebral Hemorrhage / epidemiology,  pathology*,  radiography
Cerebral Ventricles / anatomy & histology,  pathology*
Cohort Studies
Humans
Middle Aged
Prospective Studies
Retrospective Studies
Tomography, X-Ray Computed / methods
Grant Support
ID/Acronym/Agency:
P50 NS044227-019002/NS/NINDS NIH HHS
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