Intraventricular hemorrhage from ruptured aneurysm

Mohr, Gérard; Ferguson, Gary G.; Khan, Moe; Malloy, David; Watts, Reginald; Benoit, Brien G.; Weir, Bryce

doi:10.3171/jns.1983.58.4.0482

Cited by 151 publications

(52 citation statements)

References 5 publications

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“…20 The occurrence of intraventricular blood has been shown to be associated with hydrocephalus and significant mortality. 1 ' 4 ' 5 - 21 We found the presence of intraventricular blood to be significantly associated with acute hydrocephalus. There was no significant relationship however between hydrocephalus and intracisternal blood.…”

Section: Yesmentioning

confidence: 77%

Acute Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage

Mehta

Holness

Connolly

et al. 1996

Can. j. neurol. sci.

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Background: Acute hydrocephalus is a potentially treatable cause of early neurological deterioration after aneurysmal subarachnoid hemorrhage ( §AH). Methods: A retrospective study of 105 consecutive cases of aneurysmal SAH was undertaken to determine those factors significantly related to the development of acute hydrocephalus. Acute hydrocephalus was diagnosed when the bicaudate index was greater than the 95 ,h percentile for age on a CT scan within 72 hours of the ictus. Results: Thirty-one percent of the patients developed acute hydrocephalus. Grade of SAH was a significant factor for the development of acute hydrocephalus on univariate analysis as 87% of patients with acute hydrocephalus (29/32) presented with at least grade 3 (Hunt-Hess) SAH (p < 0.05). In addition, posterior circulation aneurysms on univariate analysis were associated with acute hydrocephalus (p < 0.05). Both premorbid hypertension and intraventricular blood (p < 0.05) were predictors for acute hydrocephalus, whereas intracisternal blood, age and sex were not. On multivariate linear regression analysis, factors found to be significantly associated with acute hydrocephalus were premorbid hypertension, intraventricular blood, CSF diversion and definitive shunt procedures. External ventricular drainage was not associated with any instances of rebleeding. Thirty-seven percent (10/27) of patients with acute hydrocephalus who survived were improved by pre-operative external ventricular drainage. Conclusions: Patients with acute hydrocephalus following SAH can be safely treated with external ventricular drainage. Multiple factors can be identified to predict those patients who will develop acute hydrocephalus post aneurysmal rupture. Approximately 30% of those patients with acute hydrocephalus will require definitive shunt placement. Acute hydrocephalus occurred in 31% of aneurysmal SAH patients in this series. RESUME: Hydrocephalic aigue consecutive a une hemorragie sous-arachnoidienne. Introduction: L'hydrocephalie aigue est une cause traitable de deterioration neurologique precoce suite a une hemorragie sous-arachnoidienne (HSA) due a un anevrisme. Methodes: Nous avons procdde a une etude retrospective de 105 cas consecutifs d'HSA anevrismale afin d'identifier les facteurs significativement relies au developpement de l'hydrocephalie aigue. Un diagnostic d'hydrocephalie aigue etait pose quand l'indice bicaudal etait superieur au 95 c percentile pour Page sur le CT scan fail dans les 72 heures de l'ictus. Resultats: Trente-et-un pourcent des patients ont developpe une hydrocephalic aigue. Le grade de l'HSA etait un facteur significatif du developpeinent d'une hydrocephalic aigue a I'analyse bivariee, 87% des patients avec hydrocephalic aigue (29/32) ayant presente une HSA de grade 3 (Hunt-Hess) ou plus au moment de la consultation initiale (p < 0.05). De plus, les an6vrismes impliquant la circulation posterieure etaient associes avec une hydrocephalic aigue (p < 0.05) a I'analyse univariee. Une hypertension premorbide et la presence d...

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Section: Yesmentioning

confidence: 77%

Acute Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage

Mehta

Holness

Connolly

et al. 1996

Can. j. neurol. sci.

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“…10 Ventriculocranial ratio is the ratio of ventricular width behind the frontal horns between the caudate nuclei, where the walls are nearly parallel, to width of the brain at the same level ( Figure 1). …”

Section: Hydrocephalusmentioning

confidence: 99%

Hypertensive Caudate Hemorrhage Prognostic Predictor, Outcome, and Role of External Ventricular Drainage

Liliang

Liang

et al. 2001

Stroke

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Background and Purpose —The purpose of the present study was to analyze the outcome and outcome predictors of caudate hemorrhage and role of external ventricular drainage in acute hydrocephalus. Methods —Clinical data from 36 consecutive patients with hypertensive caudate hemorrhage was used in the present study. Age, gender, volume of parenchymal hematoma, hematoma in the internal capsule, initial Glasgow Coma Scale (GCS), hydrocephalus, severity of intraventricular hemorrhage, and hemorrhagic dilatation of the fourth ventricle were analyzed for effect on outcome. Effect of external ventricle drainage for hydrocephalus was evaluated by comparing preoperative and postoperative GCS scores. Results —By univariate analyses, poor outcome was associated with a poor initial GCS score ( P =0.016), hydrocephalus ( P <0.001), intraventricular hemorrhage severity ( P <0.01), and hemorrhagic dilatation of the fourth ventricle ( P =0.02). By multivariate analysis, stepwise logistic regression revealed that hydrocephalus was the only independent prognostic factor for poor outcome ( P <0.001). Postoperative 48-hour GCS score was better than the preoperative score by use of paired-sample t test ( P <0.001). Conclusions —Hydrocephalus is the most important predictor of poor outcome. External ventricular drainage response for hydrocephalus was good in the present study, whereas an early decision should be made regarding preoperative neurological condition.

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“…Spontaneous intraventricular hemorrhage (IVH) complicates subarachnoid hemorrhage and intracerebral hemorrhage (ICH) in 15 and 40% of patients, respectively [1,2,3,4]. When the Glasgow coma score at admission is low and the volume of blood in the cavities is >20 ml, the prognosis is very poor [5,6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Application of Neuroendoscopy in the Treatment of Intraventricular Hemorrhage

Zhang¹,

Li²,

Liu³

et al. 2007

Cerebrovasc Dis

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Background: Spontaneous intraventricular hemorrhage is an infrequent but severe complication of hemorrhagic stroke. The conventional treatment of intraventricular hemorrhage consists of ventricular drainage or surgical evacuation, but neither of them is encouraged. The objective of this article is to compare different surgical procedures in order to evaluate a method of minimally invasive treatment for intraventricular hemorrhage. Methods: Neuroendoscopy was applied to treat 22 cases of intraventricular hemorrhage. Twenty cases of the same disease that were treated by external ventricular drainage were taken as a control and comparison. Results: All patients were followed up for 2 months. In the neuroendoscopy group, according to the Glasgow outcome scale, the result was excellent in 5 cases, good in 9, fair in 4, poor in 2 and death in 2. In the external ventricular drainage group, the result was excellent in 1 case, good in 5, fair in 7, poor in 5 and death in 2. More patients in the neuroendoscopy group showed good recovery after 2 months of surgery (p < 0.05). The difference in mortality rate between the 2 groups was not statistically significant (p > 0.05). Conclusions: Neuroendoscopic neurosurgery for intraventricular hemorrhage offers better surgical treatment because it is characterized by visualized manipulation, effective hemorrhage evacuation and excellent postoperative outcomes.

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Intraventricular hemorrhage from ruptured aneurysm

Cited by 151 publications

References 5 publications

Acute Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage

Acute Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage

Hypertensive Caudate Hemorrhage Prognostic Predictor, Outcome, and Role of External Ventricular Drainage

Application of Neuroendoscopy in the Treatment of Intraventricular Hemorrhage

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