Primary intraventricular hemorrhage in adults: etiological causes and prognostic factors in Chinese population

Zhang, Si; Jia, Bangsheng; Li, Hao; You, Chao; Hanley, Daniel F.; Jiang, Yan

doi:10.1007/s00415-016-8367-x

Cited by 13 publications

(16 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 ). Ruptured AVMs were the major cause of PIVH [ 33 ] and 27% of our series presented with PIVH, which was consistent with the previous studies. [ 14 , 15 ] In PIVH, with the less resistance from brain tissue, the volume of blood into ventricles and the Graeb score increased.…”

Section: Discussionsupporting

confidence: 92%

“…Compared to the poor outcomes of 31% in idiopathic IVH, the PIVH secondary to AVMs resulted in less poor outcome (11%), which was similar to the previous study (9%). [ 14 , 33 ] Theoretically, sICH had a higher trend of hematoma expansion while the AVMs-related hemorrhage were relatively stable, which could lead to this consequence. [ 22 ] The AVMs in cerebellum were more likely to present with hemorrhage compared with AVMs in lobes, [ 36 ] and we found none of AVMs in cerebellum presented as PIVH in our series.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical features and prognostic factors in patients with intraventricular hemorrhage caused by ruptured arteriovenous malformations

et al. 2017

Medicine

Self Cite

View full text Add to dashboard Cite

Intraventricular hemorrhage (IVH) was associated with poor outcomes in patients with intracerebral hemorrhage. IVH had a high incidence in patients with ruptured arteriovenous malformations (AVMs). In this study, we aimed to discuss the clinical features and prognostic factors of outcomes in the patients with AVM-related IVH.From January 2010 to January 2016, we collected the data of the patients with AVM-related IVH retrospectively. The data, including clinical and radiological parameters, were collected to evaluate the clinical features. Univariate and multivariate logistic regression analyses were used to identify the prognostic factors for clinical outcomes (hydrocephalus, 6-month outcomes measured by the modified Rankin scale) in our cohort.A total of 67 eligible patients were included and 19 patients (28%) only presented with IVH. Thirty-three patients (49%) presented hydrocephalus, and 12 patients (18%) presented brain ischemia. Nineteen patients (28%) had a poor outcome after 6 months. In multivariate logistic regression, subarachnoid hemorrhage (SAH) (P = .028) was associated with hydrocephalus and higher Graeb score (P = .080) tended to increase the risk of hydrocephalus. The high Glasgow coma scale (P = .010), large hematoma volume of parenchyma (P = .006), and high supplemented Spetzler–Martin (sup-SM) score (P = .041) were independent factors of the poor outcome.IVH was common in ruptured AVMs and increased the poor outcomes in patients with the ruptured AVMs. The AVM-related IVH patients had a high incidence of hydrocephalus, which was associated with brain ischemia and SAH. Patients with lower Glasgow coma scale, lower sup-SM score, and smaller parenchymal hematoma had better long-term outcomes.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Clinical features and prognostic factors in patients with intraventricular hemorrhage caused by ruptured arteriovenous malformations

et al. 2017

Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…The relatively rare primary IVH (without an overt ICH on CT scan), believed to represent 3% of ICH cases [28,29], presents an additional challenge due to a rather similar CT picture regardless of bleeding etiology. Hence clinical suspicion of vascular etiology in primary IVH is more dependent on baseline demographic features than the distribution of blood.…”

Section: Discussionmentioning

confidence: 99%

Demographic Risk Factors for Vascular Lesions as Etiology of Intraventricular Hemorrhage in Prospectively Screened Cases

et al. 2017

View full text Add to dashboard Cite

Background: Spontaneous intraventricular hemorrhage (IVH) is associated with high rates of morbidity and mortality despite critical care and other advances. An important step in clinical management is to confirm/rule out an underlying vascular lesion, which influences further treatment, potential for further bleeding, and prognosis. Our aim is to compare demographic and clinical characteristics between IVH patients with and without an underlying vascular lesion, and among cohorts with different vascular lesions. Methods: We analyzed prospectively collected data of IVH patients screened for eligibility as part of the Clot Lysis: Evaluation Accelerated Resolution of IVH Phase III (CLEAR III) clinical trial. The trial adopted a structured screening process to systematically exclude patients with an underlying vascular lesion as the etiology of IVH. We collected age, sex, ethnicity, and primary diagnosis on these cases and vascular lesions were categorized prospectively as aneurysm, vascular malformation (arteriovenous malformation, dural arteriovenous fistula, and cavernoma), Moyamoya disease, or other vascular lesion. We excluded cases <18 or >80 years of age. Baseline characteristics were compared between the CLEAR group (IVH screened without vascular lesion) and the group of IVH patients screened and excluded from CLEAR because of an identified vascular lesion. We further analyzed the differential demographic and clinical characteristics among subcohorts with different vascular lesions. Results: A total of 10,538 consecutive IVH cases were prospectively screened for the trial between 2011 and 2015. Out of these, 496 cases (4.7%) screened negative for underlying vascular lesion, met the inclusion criteria, and were enrolled in the trial (no vascular etiology group); and 1,205 cases (11.4%) were concurrently screened and excluded from the trial because of a demonstrated underlying vascular lesion (vascular etiology group). Cases with vascular lesion were less likely to be >45 years of age (OR 0.28, 95% CI 0.20-0.40), African-American (OR 0.23, 95% CI 0.18-0.31), or male gender (OR 0.48, 95% CI 0.38-0.60), and more likely to present with primary IVH (OR 1.85, 95% CI 1.37-2.51) compared to those with no vascular etiology (p < 0.001). Other demographic factors were associated with specific vascular lesion etiologies. A combination of demographic features increases the association with the absence of vascular lesion, but not with absolute reliability (OR 0.1, 95% CI 0.06-0.17, p < 0.001). Conclusion: An underlying vascular lesion as etiology of IVH cannot be excluded solely by demographic parameters in any patient. Some form of vascular imaging is necessary in screening patients before contemplating interventions like intraventricular fibrinolysis, where safety may be impacted by the presence of vascular lesion.

show abstract

“…Primary intraventricular hemorrhage (PIVH) accounts for 0.31% of all stroke cases and 3.1% of all spontaneous intracranial hemorrhage. 1 2 3 4 5 6 PIVH refers to nontraumatic intracranial bleeding in the ventricular system and adjacent ependymal lining without a definite parenchymal component. 7 8 9 10 PIVH is more commonly seen in preterm newborns than in adults.…”

Section: Introductionmentioning

confidence: 99%

Adult Primary Intraventricular Hemorrhage: Clinical Characteristics and Outcomes

Pai

Hegde

Nair

et al. 2020

JNRP

View full text Add to dashboard Cite

Background Adult primary intraventricular hemorrhage (PIVH) is a rare type of hemorrhagic stroke that is poorly understood. The study attempts to define the clinical profile, yield of diagnostic cerebral angiography, and prognosis of patients with PIVH. Patients and Methods Retrospective data analysis of all patients with PIVH admitted between February 2015 and February 2019 at a tertiary care center. Outcome was assessed using the modified Rankin scale (mRS) at 6 months. Results and Discussion Our study group of 30 patients constituted 3.3% (30/905) of our spontaneous intracerebral hemorrhage (SICH) patients in the study period. The mean Glasgow Coma Score on admission was 11 ± 3.33 and the mean IVH Graeb score was 5.2±2.4. All patients underwent angiography. Angiography detected moyamoya disease in four patients (13.3%) and aneurysms in two patients (6.6%) and these patients were managed surgically. Extraventricular drainage with intraventricular instillation of Streptokinase was performed in five patients. The rest of the patients was managed conservatively. At 6-month follow-up, 25 patients (83.33%) achieved favorable outcome (mRS score of 0.1 or 2), whereas five (16.66%) patients had a poor outcome (mRS score of 3 or more. Three patients succumbed to the illness. IVH Graeb score and presence of hydrocephalus have significant correlation with poor outcome. Conclusion PIVH is an uncommon entity but carries a better long-term prognosis than SICH angiography helps in diagnosing surgically remediable underlying vascular anomalies and is indicated in all cases of PIVH.

show abstract

Primary intraventricular hemorrhage in adults: etiological causes and prognostic factors in Chinese population

Cited by 13 publications

References 22 publications

Clinical features and prognostic factors in patients with intraventricular hemorrhage caused by ruptured arteriovenous malformations

Clinical features and prognostic factors in patients with intraventricular hemorrhage caused by ruptured arteriovenous malformations

Demographic Risk Factors for Vascular Lesions as Etiology of Intraventricular Hemorrhage in Prospectively Screened Cases

Adult Primary Intraventricular Hemorrhage: Clinical Characteristics and Outcomes

Contact Info

Product

Resources

About