Prognostic Factors in Spontaneous Primary Intraventricular Hemorrhage.

Cho, Young Wook; Whang, Kum; Pyen, Jhin Soo; Hu, Chul; Hong, Soon Ki; Kim, Hun Joo

Original Article

Journal of Korean Neurosurgical Society 2004;35(3): 297-301.

Young Wook Cho, Kum Whang, Jhin Soo Pyen, Chul Hu, Soon Ki Hong, Hun Joo Kim

Department of Neurosurgery, Wonju College of Medicine, Yonsei University, Wonju, Korea. whangkum@wonju.yonsei.ac.kr

ABSTRACT

OBJECTIVE
TA retrospective study is performed on 28 patients with primary intraventricular hemorrhage(PIVH) to examine the outcome and prognostic factors associated with this disorder. METHODS: Clinical data collected between 1998 and 2002 was used in the present study. The outcomes of these patients were compared by age, etiology, initial Glasgow Coma Score(GCS), Graeb's score, ventriculocranial ratio(VCR), hemorrhagic dilation of the third ventricle, and hemorrhagic dilation of the fourth ventricle. The Glasgow Outcome Scale(GOS) at discharge was used for the comparison of outcomes. RESULTS: The mean age of these patients was 48.4+/-17.4 years. The underlying causes of PIVH were hypertension(53.6%), moyamoya disease(17.9%), arteriovenous malformation(10.7%), cerebral aneurysm(7.1%), and unknown(10.7%). The age and etiology were not correlated with outcome. Patients with a GCS of 13-15 showed a good outcome in 90.5%(p<0.05). Those with a higher VCR(> or =0.23) showed a poor outcome in 64.3%(p<0.05). Patients with a Graeb's score of 9-12 showed a poor outcome in 87.5%(p<0.05). Those with hemorrhagic dilatation of the third ventricle showed a poor outcome in 80.0%, and those with hemorrhagic dilatation of the fourth ventricle showed a poor outcome in 85.7%(p<0.05). The overall mortality rate was 17.9%. CONCLUSION: Low initial GCS, high Graeb's score, high VCR, and hemorrhagic dilatation of the third ventricle or the fourth ventricle are correlated with poor outcome in PIVH.

Key Words: Primary intraventricular hemorrhage; Prognostic factor; Third ventricle; Fourth ventricle; Hemorrhagic dilatation; Ventriculocranial ratio