Document Detail


Prognostic significance of third ventricle dilation in spontaneous intracerebral hemorrhage: a preliminary clinical study.
MedLine Citation:
PMID:  18241533     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Although numerous factors have been described that predict outcome after spontaneous intracerebral hemorrhage (ICH), very little is know about the role of hemorrhagic dilation of the third ventricle in development of hydrocephalus and prognosis. The objective of this study was to investigate whether the presence of hemorrhagic third ventricle dilation after ICH would predict development of hydrocephalus and outcome. METHODS: We identified the patients with spontaneous ICH treated with external ventricular drainage (EVD) in this retrospective study. Computerized tomography (CT) was performed at admission within 24 hours of onset and retrospectively analysed to determine lesion size and location, status of third and fourth ventricle and frontal horn index (FHI). Glasgow coma scale (GCS) score, mean arterial pressure (MAP), etiology and demographic data were obtained from medical records. Outcome was determined using modified Rankin score at month 3. Patients with and without third ventricle dilation were compared in terms of hydrocephalus (FHI > 0.38), initial GCS score, age and MAP, and analyses were performed to determine whether third ventricle dilation was a predictor of poor outcome. RESULTS: Of the 22 patients studied, all had thalamic or basal ganglia hemorrhage with intraventricular hemorrhage (IVH) and all are treated with external ventricular drainage (EVD). Of the 22 patients, 12 had third ventricle dilation (width > or = 10 mm) and ten patients had non-dilated third ventricle (width < 10 mm). Patients with third ventricle dilation had lower GCS scores (7.4 +/- 1.8 versus 9.7 +/- 2.1, p < 0.005) and had higher FHI (0.46 +/- 0.06 versus 0.38 +/- 0.02, p < 0.005) as compared to patients with non-dilated third ventricle. The differences in age (59.5 +/- 9.4 versus 59.2 +/- 11.2) and MAP (128.3 +/- 16.0 versus 130.5 +/- 13.6) of the patients were not significant statistically. Sixty-six percent of patients (8/12) with third ventricle dilation and 60% of patients (6/10) with normal third ventricle were dead 6 months post-operation and mortality rate did not differ significantly. DISCUSSION: Although the roles of various factors are well described in the prognosis of spontaneous ICH, little is known about the role of third ventricle dilation. Based on our results, we concluded that third ventricle dilation is a poor prognostic factor.
Authors:
Ozgur Ozdemir; Tarkan Calisaneller; Askin Hastürk; Fatih Aydemir; Hakan Caner; Nur Altinors
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Publication Detail:
Type:  Journal Article     Date:  2008-01-31
Journal Detail:
Title:  Neurological research     Volume:  30     ISSN:  0161-6412     ISO Abbreviation:  Neurol. Res.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-06-11     Completed Date:  2008-09-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7905298     Medline TA:  Neurol Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  406-10     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Faculty of Medicine, Baskent University, Ankara, Turkey. ozgurhozdemir@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Age Factors
Aged
Basal Ganglia / pathology,  physiopathology,  radiography
Cerebral Hemorrhage / mortality*,  pathology*
Comorbidity
Disease Progression
Female
Glasgow Outcome Scale
Humans
Hydrocephalus / mortality*,  pathology*
Male
Middle Aged
Mortality
Predictive Value of Tests
Prognosis
Retrospective Studies
Thalamus / pathology,  physiopathology,  radiography
Third Ventricle / pathology*,  physiopathology,  radiography
Tomography, X-Ray Computed
Turkey

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