Intraventricular hemorrhage in adults: Clinical-computed tomographic correlations

Weisberg, Leon A.; Elliott, Debra; Shamsnia, Morteza

doi:10.1016/0895-6111(91)90108-8

Cited by 10 publications

(8 citation statements)

References 23 publications

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“…Although our sample did not include any severe cases of intraventricular hemorrhage, previous studies suggest that even mild intraventricular hemorrhage may cause damage to subcortical regions [33]. Intraventricular hemorrhage often results in ventricular expansion [4,34]. Based on our findings, there is a strong relationship between ventriculomegaly and decreased subcortical gray matter volume as described above.…”

Section: Perinatal Variables and Neuroanatomic Outcomesupporting

confidence: 50%

Volumetric analysis of regional cerebral development in preterm children

Kesler

Ment

Vohr

et al. 2004

Pediatric Neurology

158

114

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Preterm birth is frequently associated with both neuropathologic and cognitive sequelae. This study examined cortical lobe, subcortical, and lateral ventricle development in association with perinatal variables and cognitive outcome. High-resolution volumetric magnetic resonance imaging scans were acquired and quantified using advanced image processing techniques. Seventy-three preterm and 33 term control children ages 7.3-11.4 years were included in the study. Results indicated disproportionately enlarged parietal and frontal gray matter, occipital horn, and ventricular body, as well as reduced temporal and subcortical gray volumes in preterm children compared with control subjects. Birth weight was negatively correlated with parietal and frontal gray, as well as occipital horn volumes. Intraventricular hemorrhage was associated with reduced subcortical gray matter. Ventricular cerebrospinal fluid was negatively correlated with subcortical gray matter volumes but not with white matter volumes. Maternal education was the strongest predictor of cognitive function in the preterm group. Preterm birth appears to be associated with disorganized cortical development, possibly involving disrupted synaptic pruning and neural migration. Lower birth weight and the presence of intraventricular hemorrhage may increase the risk for neuroanatomic abnormality.

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Section: Perinatal Variables and Neuroanatomic Outcomesupporting

confidence: 50%

Volumetric analysis of regional cerebral development in preterm children

Kesler

Ment

Vohr

et al. 2004

Pediatric Neurology

158

114

View full text Add to dashboard Cite

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“…Our findings suggest that primary IVH cases have higher odds of harboring an underlying structural etiology compared to IVH with an intraparenchymal ICH component. Results are in keeping with previous series in literature reporting higher etiologic diagnostic yield in primary IVH ranging between 29–65% [24,30–32]. …”

Section: Discussionsupporting

confidence: 91%

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

et al. 2017

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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.

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“…However, differences in clinical features and outcome among patients grouped according to hypertensive status have also been reported by Weisberg et al. (19).…”

Section: Discussionmentioning

confidence: 66%