title: Cerebral vasospasm and delayed cerebral ischemia in intraventricular hemorrhage.
abstract: BACKGROUND
  Intracerebral hemorrhage (ICH) with intraventricular extension (IVH) is a devastating disease with a particular high mortality. In some aspects, IVH may resemble subarachnoid hemorrhage. The incidence and role of cerebral vasospasm in ICH with IVH are poorly understood. Here, we aimed to analyze the incidence and relationship of cerebral vasospasm to clinical characteristics, in-hospital mortality, and functional outcome at 3 months in patients suffering ICH with IVH.
  
  
  METHODS
  Patients with ICH and IVH treated on a neurological intensive care unit were prospectively enrolled in a single-center observational study. Vasospasm was defined using established ultrasound criteria. Delayed cerebral ischemia (DCI) was defined as a new hypodensity on follow-up cranial CT. Functional outcome at 3 months was assessed using the modified Rankin Scale.
  
  
  RESULTS
  129 patients with ICH and IVH were screened for the study. 62 patients entered the final analysis. The incidence of significant vasospasm was 37 %. A strong trend was found for the association between all cerebral vasospasm and DCI (P = 0.046). Early (up to 48 h) vasospasm was significantly associated with a DCI (P = 0.033). Overall mortality and outcome after 3 months did not differ between the groups.
  
  
  CONCLUSIONS
  Cerebral vasospasm seems to be a frequent complication after ICH with IVH and might be associated with DCI. Larger studies are warranted to confirm this hypothesis.
authors.affiliation: Department of Neurology, UniversityHospital Heidelberg, Heidelberg, Germany, jens.regula@med.uni-heidelberg.de.
authors.forename: J U
authors.initials: JU
authors.lastname: Regula
authors.forename: J
authors.initials: J
authors.lastname: Schill
authors.forename: P A
authors.initials: PA
authors.lastname: Ringleb
authors.forename: M
authors.initials: M
authors.lastname: Sykora
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000401:mortality* / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000401:mortality* / Q000503:physiopathology; D002552:Cerebral Ventricles / Q000503:physiopathology*; D003422:Critical Care; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D020301:Vasospasm, Intracranial / Q000401:mortality* / Q000503:physiopathology