Spontaneous primary intraventricular hemorrhage in adults: clinical data, etiology and outcome.
OBJECTIVE
Primary intraventricular hemorrhage (PIVH), bleeding in the ventricular system without a recognizable parenchymal component, is a rare neurological disorder. The purpose of this study was to identify clinical features, risk factors, etiology and outcome of patients with PIVH.


METHODS
We retrospectively reviewed the clinical data, complementary examinations, outcome and computed tomography (CT) IVH score of 24 patients in our hospital from 2004 to 2008. We identified 24 patients with the inclusion criteria of non-traumatic PIVH. Their mean age was 60.6+/-17.4 years (range 38-79). Fourteen patients were male and 10 were female.


RESULTS
The major symptoms included headache (n=24), loss of consciousness (n=6), confusion and disorientation (n=14), nausea/vomiting (n=10). Angiography revealed vascular malformations in five patients (21%). Other possible causative factors were hypertension in 12 patients (50%) and clotting disorder in one. The aetiology remained unknown in six patients. Most PIVH patients had associated hydrocephalus (58%) and 37% of the patients required ventricular drainage. In-hospital mortality was high (41%) and a FOUR score <or=10, GCS <or=8 and early hydrocephalus were independent predictors of mortality.


CONCLUSIONS
Hypertension is the most common associated risk factor for PIVH followed by vascular malformation. Spontaneous resorption and rebleeding may be seen. The neurological status of the patients and an early developing hydrocephalus are the most important risk factors.
Baskent University, Department of Neurology, Ankara, Turkey. sgiray72@hotmail.com
Semih
S
Giray
Orhan
O
Sen
Fevzi Birol
FB
Sarica
Kadir
K
Tufan
Mehmet
M
Karatas
Baflak Karakurum
BK
Goksel
Deniz
D
Yerdelen
Melih
M
Cekinmez
Ufuk
U
Can
D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality; D002552:Cerebral Ventricles; D014695:Cerebral Ventriculography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality; D006973:Hypertension / Q000150:complications / Q000401:mortality; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors