title: Primary intraventricular hemorrhage in adults: etiological causes and prognostic factors in Chinese population.
abstract: Primary intraventricular hemorrhage (PIVH) is a rare type of hemorrhagic stroke that is poorly understood. We aimed to explore the features of this disease in Chinese population via an institutional prospective study. Adult patients diagnosed with PIVH from January 2013 to January 2016 were enrolled in this study. Data, including clinical variables, radiological features, and yield of angiography, were collected to evaluate the clinical features, etiological causes, and prognostic factors of this disease. A total of 67 patients (73.6%) were diagnosed with PIVH which constituted 3.2% of contemporary patients with hemorrhagic stroke in our hospital. Thirty-four patients (52.3%) were diagnosed with vascular structural abnormality (VSA)-related PIVH, and the etiologies included Moyamoya disease (22.4%), arteriovenous malformations (17.9%), aneurysms (7.5%), bilateral internal carotid artery dissection (1.5%), and tumor (1.5%). Idiopathic PIVH was diagnosed in 31 patients (47.7%), including coagulopathy in 3 (4.5%). Patients with VSA-related PIVH were younger than idiopathic PIVH patients, with a mean age of 37.1 ± 14.6 years, and idiopathic PIVH patients were more commonly hypertensive. The overall mortality rate was 11.9%, and 21 patients (31.3%) had a poor outcome at the 6-month follow-up. Patients with younger age, lower Graeb score, and a known etiology of arteriovenous malformation might be associated with a favorable outcome. We recommended routine thin-slice computed tomography (CT) scan, computed tomographic angiography (CTA), and digital subtraction angiography (DSA) for patients with PIVH. The etiological causes and prognostic factors of PIVH in Chinese patients were associated with distinctive features.
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Wu Hou District, 610041, Chengdu, Sichuan, China.
authors.forename: Si
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Bangsheng
authors.initials: B
authors.lastname: Jia
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Wu Hou District, 610041, Chengdu, Sichuan, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Wu Hou District, 610041, Chengdu, Sichuan, China.
authors.forename: Chao
authors.initials: C
authors.lastname: You
authors.affiliation: Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Hanley
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Wu Hou District, 610041, Chengdu, Sichuan, China. jiangyan0118@sina.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D016896:Treatment Outcome; D055815:Young Adult
keywords: Arteriovenous malformations; Moyamoya disease; Primary intraventricular hemorrhage; Stroke