title: Primary Intraventricular Hemorrhage: Clinical Characteristics and Outcomes.
abstract: BACKGROUND
  Primary intraventricular hemorrhage (IVH) in adults is a rare neurologic disorder. The typical course, etiology, complications, and outcomes have not been well established.
  
  
  METHODS
  Consecutive patient records with a diagnosis of intracerebral hemorrhage admitted between May 2009 and June 2014 at a tertiary care center were retrospectively reviewed. Subjects were included in the study cohort if all neurologists and the radiology report agreed that the subject had an isolated IVH. Patients with intraparenchymal hemorrhage, subarachnoid hemorrhage, malignancy with hemorrhagic components, and hemorrhagic transformation of ischemic stroke were excluded. The electronic medical record, imaging report, and imaging studies were reviewed.
  
  
  RESULTS
  Of 1692 cases reviewed, 33 (1.9%) had primary IVH. The most common presenting symptoms included altered mental status (48.5%), headache, (39.4%), and nausea (24.2%). In 36.3%, hypertension was found to be a contributing factor; 27.2% were attributed solely to hypertension. Vascular abnormalities were the primary etiology in 21.3% of patients. When observing outcomes, 61.8% were discharged home or to rehab, whereas 20.5% died or were placed in hospice care. A higher Graeb score was associated with an increased likelihood of death or hospice (8 versus 5, P = .02) CONCLUSION: This study is one of few to describe the etiology, contributing factors, and outcomes of primary IVH. As in prior studies, hypertension was a contributing factor, and vascular lesions were less common than expected. More research is necessary to further define the course and characteristics of this rare type of intracerebral hemorrhage.
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Rachel
authors.initials: R
authors.lastname: Weinstein
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Ess
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Bilaal
authors.initials: B
authors.lastname: Sirdar
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Sarah
authors.initials: S
authors.lastname: Song
authors.affiliation: Warren Alpert Medical School of Brown University, Providence, Rhode Island. Electronic address: Shawna.cutting@lifespan.org.
authors.forename: Shawna
authors.initials: S
authors.lastname: Cutting
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000074042:Cerebral Intraventricular Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Graeb score; Intraventricular hemorrhage; arteriovenous malformation; cerebral angiography; hydrocephalus; intracranial hemorrhage; outcome