Delayed intraventricular hemorrhage in moderate-to-severe traumatic brain injury: prevalence, associated risk factors, and prognosis.
The presence of traumatic intraventricular hemorrhage (tIVH) on an admission CT scan is related to a worse outcome and increased mortality in patients with moderate and severe TBI. Currently, there is no available data regarding the predictive value of the appearance of tIVH as a delayed finding on follow-up CT scan. The purpose of this study was to determine the prevalence, associated risk factors, and prognosis of delayed tIVH.



The study is based on 401 consecutive adult patients (age ≥ 18 years) with moderate-to-severe TBI admitted in our hospital for a 5-year period. At least one control CT was performed in 320 (79.8 %) patients. The prevalence of delayed tIVH was assessed and the potential risk factors and mortality were analyzed.



Delayed tIVH appeared in 38 cases (11.9 % of the second CT scans and 9.5 % of all patients). The patients with delayed tIVH are significantly older (57.39 vs. 48.63 years, p = 0.009) and developed statistically significant more frequent enlargement of an existing lesion (47.4 vs. 20.2 %, p = 0.001) and appearance of a new lesion (100 vs. 33.7 %, p < 0.001). Delayed tIVH appeared significantly more frequent in surgically treated patients with ICH as a main surgical lesion (p = 0.010) and is associated with significantly higher mortality (p < 0.001).



Delayed tIVH as a progression of injury in moderate-to-severe TBI has a relatively high occurrence and is associated with increased mortality. The only factor independently related to a new appearance of tIVH is the presence of ICH as a main surgical lesion on the control preoperative CT scans.
Department of Neurosurgery, University Hospital Pirogov, 21 Totleben Blvd, 1606, Sofia, Bulgaria. mlaleva@gmail.com.
Maria
M
Laleva
Department of Neurosurgery, University Hospital Pirogov, 21 Totleben Blvd, 1606, Sofia, Bulgaria.
Nikolay
N
Gabrovsky
Department of Health Economics, Faculty of Public Health, Medical University, Sofia, Bulgaria.
Emilia
E
Naseva
Department of Neurosurgery, University Hospital Pirogov, 21 Totleben Blvd, 1606, Sofia, Bulgaria.
Nikolay
N
Velinov
Department of Neurosurgery, University Hospital Pirogov, 21 Totleben Blvd, 1606, Sofia, Bulgaria.
Stefan
S
Gabrovsky
D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
Delayed intraventricular hemorrhage; Progression; Traumatic brain injury