title: Prognostic value of intraventricular bleeding in spontaneous intraparenchymal cerebral hemorrhage of small volume:  a prospective cohort study.
abstract: BACKGROUND
  The literature is controversial on whether intraventricular bleeding has a negative impact on the prognosis of spontaneous intracerebral hemorrhage. Nevertheless, an association between intraventricular bleeding and spontaneous intracerebral hemorrhage volumes has been consistently reported.
  
  
  OBJECTIVE
  To evaluate the prognostic value of intraventricular bleeding in deep intraparenchymal hypertensive spontaneous hemorrhage with a bleeding volume <30 cm(3).
  
  
  METHODS
  Of the 320 patients initially evaluated, 33 met the inclusion criteria and were enrolled in this prospective study. The volume of intraparenchymal hemorrhage was calculated by brain computed tomography (CT) image analysis, and the volume of intraventricular bleeding was calculated by the LeRoux scale. Clinical data, including neurological complications, were collected daily during hospitalization. Neurological outcome was evaluated 30 days after the event by using the Glasgow outcome scale. Patients were assigned to 1 of 3 groups according to intraventricular bleeding: Control, no intraventricular bleeding; LR 1, intraventricular bleeding with LeRoux scale scores of 1 to 8; or LR 2, intraventricular bleeding with LeRoux scale scores >8.
  
  
  RESULTS
  There were no significant differences among groups concerning age, mean blood pressure, and time from onset to brain CT scan. Patients with greater intraventricular bleeding presented lower initial Glasgow coma scale scores, increased ventricular index and width of temporal horns, increased number of clinical and neurological complications, and longer hospitalization. Furthermore, their relative risk for unfavorable clinical outcome was 1.9 (95% confidence interval 1.25-2.49).
  
  
  CONCLUSIONS
  Intraventricular bleeding with a LeRoux scale score >8 appears to have a negative effect on deep spontaneous intraparenchymal cerebral hemorrhage of small volume.
authors: Hospital Cristo Redentor, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil. ttflima@yahoo.com.br
authors: Telmo Tiburcio
authors: TT
authors: Fortes Lima
authors: Mirto Nelso
authors: MN
authors: Prandini
authors: Pasquale
authors: P
authors: Gallo
authors: Sérgio
authors: S
authors: Cavalheiro
mesh_terms: D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology*; D002552:Cerebral Ventricles / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014057:Tomography, X-Ray Computed