| Impact of Intraventricular Hemorrhage on Clinical Outcome in Large Spontaneous Intracerebral Hemorrhage Patients |
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Ho-Soo Kim* , Sung-Un Lee , Joon-Suk Song , Gi-Chang Lee |
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Department of Neurosurgery, Wallace Memorial Baptist Hospital, Busan, Korea
*Department of Neurosurgery, Busan Paik Hospital, Inje University, Busan, Korea. Moved from Wallace Memorial Baptist Hospital |
| 큰 자발성 뇌실질내 출혈 환자에서 뇌실내 출혈의 임상 결과에 미치는 영향 |
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김호수*·이성운·송준석·이기창 |
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왈레스기념 침례병원 신경외과 |
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| Abstract |
Objective
The most common cause of nontraumatic intraventricular hemorrhage (IVH) is spontaneous intracerebral hemorrhage (SICH). In SICH patients, combined IVH has been known as fatal feature and independent prognostic factor. Thus the treatment of IVH is very determinanting factor for the patient’s outcome. But almost studies have focused on IVH in small SICH (<30mL). In large SICH (>30mL), it is questionable whether its results are same or not. We focused on IVH in large SICH and analyzed it.
Methods
From January 2007 to December 2013, 533 consecutive patients of SICH who admitted to Wallace Memorial Baptist Hospital were reviewed and those data were analyzed retrospectively. Among those, 56 patients whose SICH is volume of >30mL, supratentorial, not from neoplasm or vascular disease (e.g. aneurysm, arteriovenous malformation, moyamoya disease and et al.) were selected. We divided them into 3 groups that are non IVH group (control group, Graeb’s core 0), mild IVH group (Graeb’s score 1-6) and severe IVH group (Graeb’s score 7-12). Outcomes at discharge were evaluated. Comparisons between groups and analyses in groups were performed.
Results
In 56 patients of large SICH, non IVH patients (control group) were 14 (25%), IVH patients (sum of mild and severe IVH group) were 42 (75%). There were no differences in clinical outcomes between each group. All groups presented highly unfavorable outcomes. In IVH group (mild and severe), Graeb’s grade and midline shifting had an influence on the mortality. IVH grade was high in male but volume of ICH was not correlated with IVH Graeb’s grade.
Conclusion
IVH in large (>30 cc) SICH patients had no significant impact on outcome. However, the mortality and hydrocephalus increased in concordance with IVH grade. Therefore IVH should be removed as soon as possible. |
| Key Words:
Intracerebral hemorrhageㆍIntraventricular hemorrhageㆍPatient outcome assessment |
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