Intraventricular hemorrhage expansion in patients with spontaneous intracerebral hemorrhage
| Autor: | Jens Witsch, Angela Velazquez, Eliza Bruce, Emma Meyers, Sureerat Suwatcharangkoon, E. Sander Connolly, M Cristina Falo, Sachin Agarwal, Soojin Park, J. Michael Schmidt, Jan Claassen |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Radiography Logistic regression Article Cerebral Ventricles Hematoma Modified Rankin Scale medicine Humans cardiovascular diseases Spontaneous intracerebral hemorrhage Aged Cerebral Hemorrhage Aged 80 and over business.industry Middle Aged medicine.disease Surgery Intraventricular hemorrhage Treatment Outcome Cohort Mann–Whitney U test Disease Progression Female Neurology (clinical) business Follow-Up Studies |
| Zdroj: | Neurology. 84(10) |
| ISSN: | 1526-632X |
| Popis: | To evaluate whether delayed appearance of intraventricular hemorrhage (dIVH) represents an independent entity from intraventricular hemorrhage (IVH) present on admission CT or is primarily related to the time interval between symptom onset and admission CT.A total of 282 spontaneous intracerebral hemorrhage (ICH) patients, admitted February 2009-March 2014 to the neurological intensive care unit of a tertiary care university hospital, were prospectively enrolled in the ICH Outcomes Project. Multivariate logistic regression was used to determine associations with acute mortality and functional long-term outcome (modified Rankin Scale).A cohort of 282 ICH patients was retrospectively studied: 151 (53.5%) had intraventricular hemorrhage on initial CT scan (iIVH). Of the remaining 131 patients, 19 (14.5%) developed IVH after the initial CT scan (dIVH). The median times from symptom onset to admission CT were 1.1, 6.0, and 7.4 hours for the dIVH, iIVH, and no IVH groups (Mann-Whitney U test, dIVH vs iIVH, p0.001) and median time from onset to dIVH detection was 7.2 hours. The increase in ICH volume following hospital admission was larger in dIVH than in iIVH and no IVH patients (mean 17.6, 0.2, and 0.4 mL). After controlling for components of the ICH score and hematoma expansion, presence of IVH on initial CT was associated with discharge mortality and poor outcome at 3, 6, and 12 months, but dIVH was not associated with any of the outcome measures.In ICH patients, associated IVH on admission imaging is commonly encountered and is associated with poor long-term outcome. In contrast, dIVH on subsequent scans is far less common and does not appear to portend worse outcome. |
| Databáze: | OpenAIRE |
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