Clinical-Computed Tomographic Correlation of Spontaneous Intraventricular Hemorrhage Patients.

Hwang, Sun Chul; Kim, Bum Tae; Chang, Jae Chil; Joo, Kyo Sung; Shin, Won Han; Choi, Soon Kwan; Byun, Bark Jang

Original Article

Journal of Korean Neurosurgical Society 1998;27(6): 784-791.

Sun Chul Hwang, Bum Tae Kim, Jae Chil Chang, Kyo Sung Joo, Won Han Shin, Soon Kwan Choi, Bark Jang Byun

Department of Neurosurgery, College of Medicine, Soonchunhyang University, Seoul, Korea.

ABSTRACT

Little has been known about clinical outcome in computed tomography(CT) documented intraventricular hemorrhage (IVH), especially in the third and fourth ventricles. A series of 114 patients with IVH in spontaneous intracranial hemorrhage diagnosed by CT, from January 1994 to December 1996, were studied retrospectively. The clinical findings, especially Glasgow Outcome Score(GOS), of these patient were compared with computed tomographic parameters on the Graeb's score, evidence of third ventricular hemorrhage, patency of fourth ventricle and hemorrhagic dilatation of fourth ventricle. The results were as following: 1) The underlying etiologies, in descending order, were hypertensive intracerebral hemorrhage(61.4%), subarachnoid hemorrhage(16.7%), moyamoya disease(13.2%), vascular malformation(5.3%), and unknown cause(3.5%). Moyamoya disease was the most common cause of pure IVH. 2) The bifrontal index (BFI), as an indicator of acute hydrocephalus after IVH, was closely correlated with consciousness level on admission, but not with GOS. 3) Graeb's score was correlated with GOS, but not with the volume of the intracerebral hematoma. 4) The third ventricular hemorrhage was associated with a worse outcome and hemorrhagic dilatation(>10.0mm) was associated with high mortality. 5) The absence of patency and the lateral dilatation(>20.0mm) in the fourth IVH was correlated with outcome. 6) In patients having the hemorrhagic dilatation of the fourth ventricle, Graeb's score and volume of intracerebral hematoma did not affect the outcome. In conclusion, Graeb's score, hemorrhagic dilatation of third ventricle, absence of fourth ventricle patency and lateral dilatation of the fourth ventricular hemorrhage in CT findings are correlated with the outcome in spontaneous IVH.