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Intraventricular hemorrhage and hydrocephalus after spontaneous intracerebral hemorrhage: Results from the STICH trial

Lookup NU author(s): Parameswaran Bhattathiri, Dr Barbara Gregson, Emeritus Professor David Mendelow


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Introduction. Intraventricular hemorrhage (IVH), either independent of or as an extension of intracranial bleed, is thought to carry a grave prognosis. Although the effect of IVH on outcome in patients with subarachnoid hemorrhage has been extensively reviewed in the literature, reports of spontaneous intracerebral hemorrhage (ICH) in similar situations have been infrequent. The association of hydrocephalus in such situations and its influence on outcome is also uncertain. Patients and methods. As a sub-analysis of data obtained through the international Surgical Trial in Intracerebral Hemorrhage (STICH), the impact of IVH, with or without the presence of hydrocephalus, on outcome in patients with spontaneous ICH was analyzed. CT scans of randomized patients were examined for IVH and/or hydrocephalus. Other characteristics of hematoma were evaluated to see if they influenced outcome, as defined by the STICH protocol [9]. Results. Favorable outcomes were more frequent when IVH was absent (31.4%, vs. 15.1%; p < 0.00001). The presence of hydrocephalus lowered the likelihood of favorable outcome still further to 11.5% (p = 0.031). In patients with IVH, early surgical intervention had a more favorable outcome (17.8%) compared to initial conservative management (12.4%) (p = 0.141). Conclusion. The presence of IVH and hydrocephalus are independent predictors of poor outcome in spontaneous ICH. Early surgery is of some benefit in those with IVH.

Publication metadata

Author(s): Mendelow AD; Gregson B; Bhattathiri PS; Prasad KSM

Editor(s): Hoff, J.T., Keep, R.F., Xi, G., Hua, Y.

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Acta Neurochirurgica Supplementa: Brain Edema XIII

Year of Conference: 2006

Pages: 65-68

ISSN: 0065-1419

Publisher: Springer

Library holdings: Search Newcastle University Library for this item

ISBN: 3211307125