title: Prognostic significance of delayed intraventricular haemorrhage in the INTERACT studies.
abstract: OBJECTIVE
  Intraventricular extension of intracerebral haemorrhage (ICH) predicts poor outcome, but the significance of delayed intraventricular haemorrhage (dIVH) is less well defined. We determined the prognostic significance of dIVH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trials (INTERACT 1 and 2).
  
  
  METHODS
  Pooled analyses of the INTERACT CT substudies-international, multicentre, prospective, open, blinded end point, randomised controlled trials of patients with acute spontaneous ICH and elevated systolic blood pressure (SBP)-randomly assigned to intensive (<140 mm Hg) or guideline-based (<180 mm Hg) SBP management. Participants had blinded central analyses of baseline and 24 h CTs, with dIVH defined as new intraventricular haemorrhage (IVH) on the latter scan. Outcomes of death and major disability were defined by modified Rankin Scale scores at 90 days.
  
  
  RESULTS
  There were 349 (27%) of 1310 patients with baseline IVH, and 107 (11%) of 961 initially IVH-free patients who developed dIVH. Significant associations of dIVH were prior warfarin anticoagulation, high (≥15) baseline National Institutes of Health Stroke Scale score, larger (≥15 mL) ICH volume, greater ICH growth and higher achieved SBP over 24 h. Compared with those who were IVH-free, dIVH had greater odds of 90-day death or major disability versus initial IVH (adjusted ORs 2.84 (95% CI 1.52 to 5.28) and 1.87 (1.36 to 2.56), respectively (p trend <0.0001)).
  
  
  CONCLUSIONS
  Although linked to factors determining greater ICH growth including poor SBP control, dIVH is independently associated with poor outcome in acute small to moderate-size ICH.
  
  
  BACKGROUND
  NCT00226096 and NCT00716079.
authors.affiliation: The George Institute for Global Health, Sydney, Australia.
authors.forename: Tom J
authors.initials: TJ
authors.lastname: Moullaali
authors.affiliation: The George Institute for Global Health, Sydney, Australia.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Sato
authors.affiliation: The George Institute for Global Health, Sydney, Australia.|Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Xia
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Alejandro A
authors.initials: AA
authors.lastname: Rabinstein
authors.affiliation: The George Institute for Global Health, Sydney, Australia.|Sydney Medical School, The University of Sydney, Sydney, Australia.|Center for Epidemiologic Research in Asia, Shiga University of Medical Sciences, Shiga, Japan.
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.affiliation: The George Institute for Global Health, Sydney, Australia.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Carcel
authors.affiliation: Department of Neurology, Xuzhou Central Hospital, Jiangsu, China.
authors.forename: Guofang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases, University of Leicester, Leicester, UK.
authors.forename: Thompson
authors.initials: T
authors.lastname: Robinson
authors.affiliation: The George Institute for Global Health, Sydney, Australia.|Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Heeley
authors.affiliation: The George Institute for Global Health, Sydney, Australia.|Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Edward
authors.initials: E
authors.lastname: Chan
authors.affiliation: The George Institute for Global Health, Sydney, Australia.|Sydney Medical School, The University of Sydney, Sydney, Australia.|Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Candice
authors.initials: C
authors.lastname: Delcourt
authors.affiliation: Department of Neurology, CRCHUM, APHP-Hôpital Lariboisière, Paris, France.|Département de Neurosciences, Université de Montréal, Montréal, Quebec, Canada.
authors.forename: Christian
authors.initials: C
authors.lastname: Stapf
authors.affiliation: University of Lille, CHRU, INSERM U 1171, Lille, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Cordonnier
authors.affiliation: The George Institute for Global Health, Sydney, Australia.|Sydney Medical School, The University of Sydney, Sydney, Australia.|Westmead Hospital Clinical School, Sydney, Australia.
authors.forename: Richard I
authors.initials: RI
authors.lastname: Lindley
authors.affiliation: The George Institute for Global Health, Sydney, Australia.|Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Chalmers
authors.affiliation: The George Institute for Global Health, Sydney, Australia.|Sydney Medical School, The University of Sydney, Sydney, Australia.|Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Anderson
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality; D002552:Cerebral Ventricles / Q000098:blood supply* / Q000000981:diagnostic imaging; D004185:Disability Evaluation; D005260:Female; D006470:Hemorrhage / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors