Acute post-traumatic intraventricular hemorrhage analysis of 25 patients with emphasis on final outcome

Abstract

A series of 25 patients suffering acute post-traumatic intraventricular hemorrhage (IVH) after closed head injury is reviewed. Post-traumatic IVH was associated with other brain lesion in most cases; intracerebral lesions with contusion, subdural hematoma, and epidural hematoma coexisted with post-traumatic IVH in ten, three, and one instance, respectively. In six cases, no CT abnormality other than IVH was noted. The final outcome in this series is poor, only 10 (40%) patients made a functional survival. Four different groups of IVH were proposed according to the CT scan findings: deep nuclei hemorrhage, brain stem injury, white matter hemorrhage and isolated IVH. The group of isolated IVH usually got a good outcome. The abnormal motor response, abnormal pupil reaction and impaired oculocephalic response were reliable parameters for poor prognosis.

The Utility of Electroencephalography and Cerebral Computed Tomography in Children with Mild and Moderately Severe Closed Head Injuries*

“…Especially the presence of intraventricular hemorrhage was indicative of a very poor prognosis, with only half of the patients being independent at a 6-months follow-up. The occurrence of intraventricular hemorrhage was found in 1.5 to 3 % of all patients with nonmissile head trauma and in nearly 10 % of patients with severe head injury (11,12). Moreover, it is weH documented in head injury reports (6, 13) that younger patients fare better than older ones.…”

“…CT scanning of the brain provides information conceming the gross structure of tissue. Several studies showed that CT scan abnormalities increase proportionally with the clinical severity of head injuries (3, 11,12,13,15,28,29).…”

Prognostic value of the Marshall computed tomography classification for traumatic subarachnoid hemorrhage

“…This is also associated with higher morbidity and mortality. tIVH was considered to be an independent predictor in previous studies [8] and not only caused by the association to other predictors [9][10][11]. However, the mechanisms by which tSAH has an additional negative effect on patient outcomes are poorly understood.…”

Presentations and Outcomes of Children With Intraventricular Hemorrhages After Blunt Head Trauma

“…In adults, traumatic IVH is associated with a mortality rate of 22% to 62.5%. 13,18,19 Children with posttraumatic IVHs may experience equally serious outcomes, including death. 11,12,20 However, to our knowledge, no previous prospective, pediatric, observational cohort studies of traumatic IVH exist; therefore, the true prevalence and out-comes have been unknown.…”

“…Most reported cases of IVHs are also associated with other ICIs. 10,12,13 The cause of reported poor outcomes in patients with IVHs and other associated head injuries is unclear but may be a consequence of intraventricular blood migrating from nearby mechanically disrupted tissues. Intraventricular hemorrhages in association with other ICIs, such as subdural hematomas, shearing injuries, brain contusions, and intracerebral hemorrhages, may be a marker of greater injury to the brain and poor prognosis.…”