Computed tomographic diagnosis of intraventricular hemorrhage. Etiology and prognosis.

Abstract

Sixty-eight patients with intraventricular hemorrhage (IVH) diagnosed by computed tomography (CT) were reviewed retrospectively to determine the etiology and prognosis, relationship to delayed hydrocephalus, and effect on neurological outcome. The most common causes were a ruptured aneurysm, trauma, and hypertensive hemorrhage. Ruptured aneurysms of the anterior communicating artery can often be predicted from the nonenhanced CT scan. The total mortality rate was 50%; however, 21% of patients returned to normal or had only mild disability. Patients in whom no cause was identified had a better prognosis. Delayed hydrocephalus was related to the effects of subarachnoid hemorrhage rather than obstruction of the ventricular system by blood. IVH per se is seldom a major factor in the neurological outcome.

Comparison of Clinical Outcomes of Intraventricular Hematoma Between Neuroendoscopic Removal and Extraventricular Drainage

“…The procedure was performed under general anesthesia during the hyperacute phase within 6 hours of onset. A 3-cm longitudinal incision was made to drill an elliptical burr hole (2-cm major axis) using an air drill at a location 2.5 cm lateral and 4 cm anterior to the bregma, on the same side as the Table 1 Grading system for intraventricular hematoma reported by Graeb et al 2) Lateral ventricle score*:…”

“…Cranial computed tomography (CT) was performed on the day following neuroendoscopic removal, and the pre-and postoperative hematoma volumes were assessed using the Graeb score (Table 1). 2) EVD used a catheter placed in the anterior horn via precoronal perforation on the same side as the source of bleeding. Bilateral catheters were used for hematoma in the bilateral lateral ventricles.…”

Traumatic Intracranial Hematomas: Prognostic Value of Contrast Extravasation

“…Up to 9 hematomas were evaluated per patient (allowing up to 4 traumatic intracerebral hematomas, 3 subdural hematomas, and 2 epidural hematomas per patient; the largest lesions were considered if there were Ͼ9 hematomas in a given patient). NCCTs were also assessed for subarachnoid hemorrhage presence, maximal SAH thickness, and IVH presence graded according to the score of Graeb et al 27 This score is a 12-point grading system based on the amount and distension of the 4 ventricles by IVH. Septum pellucidum shift was measured at the level of the foramen of Monro.…”

Relationship between Baseline White Blood Cell and C-Reactive Protein with Mortality in Patients with Spontaneous Intracerebral Hemorrhage

“…sICH hematoma volume was measured with the use of the ABC/2 method, in which A is the greatest diameter on the largest hemorrhage slice, B is the diameter perpendicular to A and C is the approximate number of axial slices with hemorrhage multiplied by the slice thickness [24].Midline shift was determined by measuring the displacement of the septum pellucidum across midline, using as reference a perpendicular line connecting the anterior and posterior insertions of the falx cerebri at the level of the lateral ventricles and third ventricle [25]. The presence or absence of IVH was also noted on initial head CT and graded according to Graeb scale [26]. Hydrocephalus was determined with the Diringer's method [27].…”