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Prognostic significance of third ventricle blood volume in intracerebral haemorrhage with severe ventricular involvement.
MedLine Citation:
PMID:  21515556     Owner:  NLM     Status:  Publisher    
Background and purpose Intraventricular haemorrhage (IVH) is an independent predictor of poor outcome in spontaneous intracerebral haemorrhage (ICH). Larger IVH volume and increasing number of affected ventricles have been associated with worse prognosis, however, little is known about the prognostic value of blood volume in the different parts of the ventricular system. Therefore, the correlation of IVH volume in the third, fourth and lateral ventricles with outcome in patients with ICH and severe IVH, treated with intraventricular fibrinolysis (IVF), was investigated. Methods Patients with ICH <40&emsp14;ml, severe IVH and acute hydrocephalus were treated with IVF. The course of IVH volume for each ventricle was measured by CT based volumetry. Outcome at 90&emsp14;days was assessed by a telephone follow-up survey and correlated with initial IVH volume. Results 50 patients aged 62.5±10.3&emsp14;years with spontaneous ICH (12.5±10.8&emsp14;ml) and severe IVH (33.5±25&emsp14;ml) were included. Clearance of the third and fourth ventricle from blood occurred after 3±1.9&emsp14;days. Initial IVH volume in the third ventricle (3.8±3.3&emsp14;ml) was predictive for poor outcome (OR 2.6 per ml, p=0.02). Correlation between larger IVH volume in the fourth ventricle and poor outcome showed a trend towards significance (p=0.07). Total IVH volume and lateral ventricle IVH volume were not correlated with outcome. Conclusion Despite rapid clot removal, initial IVH volume in the third ventricle was a strong and independent negative predictor. This is possibly explained by irreversible damage of brainstem structures by the initial mass effect of IVH.
Dimitre Staykov; Bastian Volbers; Ingrid Wagner; Hagen B Huttner; Arnd Doerfler; Stefan Schwab; Juergen Bardutzky
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-21
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  -     ISSN:  1468-330X     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Neurology, University of Erlangen, Erlangen, Germany.
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