HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hallevi, H. Articles by Grotta, J. C. Search for Related Content PubMed PubMed Citation Articles by Hallevi, H. Articles by Grotta, J. C. Related Collections Natural history studies (prognosis) Intracerebral hemorrhage

Intraventricular hemorrhage

Anatomic relationships and clinical implications

From the Department of Neurology (H.H., J.A., A.D.B., S.M.-S., A.M.K., N.R.G., K.I., E.A.N., J.C.G.), University of Texas–Houston Medical School; and Mayo Clinic Jacksonville (K.C.A.), FL.

Address correspondence and reprint requests to Dr. Hen Hallevi, Department of Neurology, 6431 Fannin Street, MSB 7.044, Houston, TX 77030 hen.hallevi{at}uth.tmc.edu

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.

GLOSSARY: ANOVA = analysis of variance; EVD = external ventricular drainage; HSD = honestly significant differences; ICC = interclass correlation coefficient; ICH = intracerebral hemorrhage; IVH = intraventricular hemorrhage; LOS = length of stay; mRS = modified Rankin Scale.

Disclosure: The authors report no conflicts of interest.

Received June 19, 2007. Accepted in final form September 17, 2007.

This article has been cited by other articles:

				Clinical Implications of Intraventricular Hemorrhage Journal Watch Neurology, September 9, 2008; 2008(909): 1 - 1. [Full Text]