1
|
Hypertensive primary intraventricular hemorrhage: a systematic review. Neurosurg Rev 2022; 45:2013-2026. [DOI: 10.1007/s10143-022-01758-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 01/26/2022] [Accepted: 02/15/2022] [Indexed: 10/19/2022]
|
2
|
Pai A, Hegde A, Nair R, Menon G. Adult Primary Intraventricular Hemorrhage: Clinical Characteristics and Outcomes. J Neurosci Rural Pract 2020; 11:623-628. [PMID: 33144801 PMCID: PMC7595788 DOI: 10.1055/s-0040-1716770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background
Adult primary intraventricular hemorrhage (PIVH) is a rare type of hemorrhagic stroke that is poorly understood. The study attempts to define the clinical profile, yield of diagnostic cerebral angiography, and prognosis of patients with PIVH.
Patients and Methods
Retrospective data analysis of all patients with PIVH admitted between February 2015 and February 2019 at a tertiary care center. Outcome was assessed using the modified Rankin scale (mRS) at 6 months.
Results and Discussion
Our study group of 30 patients constituted 3.3% (30/905) of our spontaneous intracerebral hemorrhage (SICH) patients in the study period. The mean Glasgow Coma Score on admission was 11 ± 3.33 and the mean IVH Graeb score was 5.2±2.4. All patients underwent angiography. Angiography detected moyamoya disease in four patients (13.3%) and aneurysms in two patients (6.6%) and these patients were managed surgically. Extraventricular drainage with intraventricular instillation of Streptokinase was performed in five patients. The rest of the patients was managed conservatively. At 6-month follow-up, 25 patients (83.33%) achieved favorable outcome (mRS score of 0.1 or 2), whereas five (16.66%) patients had a poor outcome (mRS score of 3 or more. Three patients succumbed to the illness. IVH Graeb score and presence of hydrocephalus have significant correlation with poor outcome.
Conclusion
PIVH is an uncommon entity but carries a better long-term prognosis than SICH angiography helps in diagnosing surgically remediable underlying vascular anomalies and is indicated in all cases of PIVH.
Collapse
Affiliation(s)
- Aswin Pai
- Department of Neurosurgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ajay Hegde
- Department of Neurosurgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajesh Nair
- Department of Neurosurgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Girish Menon
- Department of Neurosurgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
3
|
Baker AD, Rivera Perla KM, Yu Z, Dlugash R, Avadhani R, Mould WA, Ziai W, Thompson RE, Staykov D, Hanley DF. Fibrinolytic for treatment of intraventricular hemorrhage: A meta-analysis and systematic review. Int J Stroke 2017; 13:11-23. [PMID: 28920538 DOI: 10.1177/1747493017730745] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Intraventricular hemorrhage is a significant cause of mortality and morbidity worldwide. Treating intraventricular hemorrhage with intraventricular fibrinolytic therapy via a catheter is becoming an increasingly utilized intervention. Aims This meta-analysis aimed to investigate the role of intraventricular fibrinolytic treatment in hypertensive intraventricular hemorrhage patients and evaluate the effect sizes for survival as well as level of function at differing time points. Summary of review PubMed, CNKI, VIP, and Wanfang were searched using the terms "IVH" and "IVH and ICH" for human studies with adult patients published between January 1950 and July 2016. Seventeen publications were selected. Data analysis showed lower rates of mortality in the treatment group at 30 days ( P < 0.001), 180 days ( P = 0.001), 365 days ( P = 0.40), and overall ( P < 0.001). Pooling modified Rankin Scale and Glasgow outcome scale data, the treatment group had more good functional outcomes at 30 days ( P = 0.38), 90 days ( P = 0.04), 180 days ( P = 0.31), 365 days ( P = 0.76), and overall ( P = 0.02). Good functional outcome was defined as modified Rankin Scale score of 0 to 3 or a Glasgow outcome scale score of 3 to 5. Conclusions Intraventricular fibrinolytic for treatment of hypertensive intraventricular hemorrhage reduces mortality and potentially leads to an increased number of good functional outcomes. Different functional outcome scales (modified Rankin Scale or Glasgow outcome scale) produce different effect sizes. Intraventricular fibrinolytic treatment may offer intraventricular hemorrhage patients a targeted therapy that produces meaningful mortality benefit and possible functional outcome benefits.
Collapse
Affiliation(s)
- Alexandra Delaney Baker
- 1 School of Medicine, Brain Injury Outcomes Division, Johns Hopkins University, Baltimore, MD, USA
| | | | - Zhiyuan Yu
- 1 School of Medicine, Brain Injury Outcomes Division, Johns Hopkins University, Baltimore, MD, USA.,2 Department of Neurosurgery, Sichuan University, West China School of Medicine, Chengdu, China
| | - Rachel Dlugash
- 1 School of Medicine, Brain Injury Outcomes Division, Johns Hopkins University, Baltimore, MD, USA
| | - Radhika Avadhani
- 1 School of Medicine, Brain Injury Outcomes Division, Johns Hopkins University, Baltimore, MD, USA
| | - William Andrew Mould
- 1 School of Medicine, Brain Injury Outcomes Division, Johns Hopkins University, Baltimore, MD, USA
| | - Wendy Ziai
- 3 Department of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Richard E Thompson
- 1 School of Medicine, Brain Injury Outcomes Division, Johns Hopkins University, Baltimore, MD, USA
| | - Dimitre Staykov
- 4 Department of Neurology, Hospital of the Brothers of St. John, Eisenstadt, Austria
| | - Daniel F Hanley
- 1 School of Medicine, Brain Injury Outcomes Division, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|