The prognosis of intraventricular haemorrhage

Weerd, A.W. de

doi:10.1016/0303-8467(79)90041-6

Cited by 7 publications

(8 citation statements)

References 12 publications

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“…44 In the present series, the prognosis was poor in a univariate analysis that included hypertension as cause of ICH and ventricular extension, which was associated with the ICH located in the basal ganglia.…”

Section: Discussionmentioning

confidence: 54%

Intracerebral Hemorrhage in Young People

Ruiz-Sandoval

Cantú

Barinagarrementería

1999

Stroke

202

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Background and Purpose-The frequency of intracerebral hemorrhages (ICHs) in people aged Յ40 years has been poorly studied. We investigated the incidence, causes, locations, and prognosis of ICH in young patients. Methods-We evaluated all consecutive patients with neuroimaging evidence or pathological confirmation of symptomatic ICH. We excluded patients with primary subarachnoid or traumatic hemorrhage, past evidence of vascular malformation, or brain tumor. We analyzed the risk factors, number, locations, and causes of ICH, and final outcome measured by the modified Glasgow Outcome Scale. Results-We retrospectively evaluated 200 patients (mean age, 27 years; range, 15 to 40 years). The most frequent risk factors were tobacco use (20%), hypocholesterolemia (35%), hypertension, (13%), and alcohol use (10%). The locations of ICH were lobar (55%), basal ganglia/internal capsule (22%), and others (24%). The most common causes of ICH were vascular malformations (49%), including cavernous angioma, and hypertension (11%). Cryptogenic ICH was considered in 15%. Other causes included cerebral venous thrombosis (5%) and sympathomimetic drug use (4%). The majority of patients with ICH that resulted from hypertension were aged Ͼ31 years (odds ratio, 3.48), and those with ICH that resulted from arteriovenous malformations were aged Ͻ20 years (odds ratio, 2.80). The final outcome was considered favorable in 60%. Conclusions-ICHs

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Section: Discussionmentioning

confidence: 54%

Intracerebral Hemorrhage in Young People

Ruiz-Sandoval

Cantú

Barinagarrementería

1999

Stroke

202

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“…In selected cases, surgical evacuation of intraparenchymal and intraventricular hematomas has resulted in decreases in mortality rates and disability. 12 However, surgery is invasive and is not always feasible. Survival after primary IVH is common, 27 but it is accompanied by considerable morbidity.…”

Section: External Ventricular Drainagementioning

confidence: 99%

“…14,22 When IVH extends into all 4 ventricles, mortality has been reported as 60%-91%. 4,6,12,18,40 With respect to the location of the hematoma causing the IVH, the worst prognosis is found with hematomas located in the thalamus. 18 Predictors of poor outcome are GCS score on presentation and the volume of blood in the ventricle system.…”

Section: External Ventricular Drainagementioning

confidence: 99%

External ventricular drainage alone versus endoscopic surgery for severe intraventricular hemorrhage: a comparative retrospective analysis on outcome and shunt dependency

Basaldella

Marton

Fiorindi

et al. 2012

FOC

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Object Massive intraventricular hemorrhages (IVHs) require aggressive and rapid management to decrease intracranial hypertension, because the amount of intraventricular blood is a strong negative prognostic predictor on outcome. Neuroendoscopy may offer some advantages over more traditional surgical approaches on outcome and may decrease the number of shunt procedures that need to be performed. Methods The authors retrospectively reviewed the clinical and radiological data in 96 patients treated for massive IVH who were admitted between January 1996 and June 2008 to the neurosurgery unit after undergoing emergency CT scanning. Forty-eight patients (Group A) were treated with endoscopic aspiration surgery using a flexible endoscope with a “freehand” technique. A historical group of 48 patients (Group B) treated using external ventricular drain (EVD) placement alone was used as a comparison. The authors compared the radiological results with the clinical outcomes at 1 year according to the modified Rankin Scale and the need for internal CSF shunt treatment in the 2 groups. Results Endoscopic aspiration did not significantly affect the outcome at 1 year as determined using the modified Rankin Scale. Patients who underwent endoscopy had an EVD in place for 0.18 days fewer than patients treated with an EVD alone. Patients undergoing external ventricular drainage alone had a 5 times greater chance of requiring a shunting procedure than those treated using neuroendoscopy and external ventricular drainage. Neuroendoscopy plus external drainage reduces shunting rates by 34% when compared with external drainage alone. Conclusions The reduction in internal shunt surgery encourages the adoption of neuroendoscopic aspiration of severe IVH as a therapeutic tool to decrease shunt dependency.

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“…76 Coma, ICH volume (>60 mL), and advanced age independently predict high mortality. 77,78 Thirty-day mortality post ICH decreased from 88% to 58% following introduction of computerized tomography. This contrasts early clinical diagnoses of severe ICH compared to a patient population including less severe hemorrhages.…”

Section: Moving From Resuscitative To End-of-life or Palliative Treatmentioning

confidence: 99%

A Model for Emergency Department End‐of‐life Communications After Acute Devastating Events—Part II: Moving From Resuscitative to End‐of‐life or Palliative Treatment

Limehouse

Feeser

Bookman

et al. 2012

Academic Emergency Medicine

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The model for emergency department (ED) end-of-life communications after acute devastating events addresses decision-making capacity, surrogates, and advance directives, including legal definitions and application of these steps. Part II concerns communications moving from resuscitative to palliative and end-of-life treatments. After completing the steps involved in determining decision-making, emergency physicians (EPs) should consider starting palliative measures versus continuing resuscitative treatment. As communications related to these end-of-life decisions increasingly fall within the scope of emergency medicine (EM) practice, we need to become educated about and comfortable with them.

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The prognosis of intraventricular haemorrhage

Cited by 7 publications

References 12 publications

Intracerebral Hemorrhage in Young People

Intracerebral Hemorrhage in Young People

External ventricular drainage alone versus endoscopic surgery for severe intraventricular hemorrhage: a comparative retrospective analysis on outcome and shunt dependency

A Model for Emergency Department End‐of‐life Communications After Acute Devastating Events—Part II: Moving From Resuscitative to End‐of‐life or Palliative Treatment

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