Adult Intraventricular Hemorrhage

Abstract

Objective: Unlike intraventricular hemorrhage (IVH) occurring in neonates, the natural history of IVH in adults is yet to be clarified. Restoration of patency of the ventricular pathway and avoidance of development of hydrocephalus are the main goals in therapy of IVH. The aim of this study was to assess the natural history, presentations, and evolution of hydrocephalus in adult IVHs. Methods: Fifty-four adult cases with IVH admitted to the neurosurgical emergency unit were included in the study. Clinical and imaging data were correlated with clinical outcome. Results: IVH in adults predominated in men over 40 years of age. The most common causes were hypertension (52%), trauma (15%), intraventricular arteriovenous malformation (7.5%), coagulopathy (7.5%), diabetic vasculopathy (7.5%), anterior communicating artery aneurysms (3%), and undetectable cause (7.5%). Primary IVH occurred in 10 (18.5%) patients, whereas secondary IVH occurred in 44 (81.5%) patients. Hydrocephalus occurred in 18 (33.3%) patients in linear correlation with the number of ventricles filled with blood and with the severity of the IVH. The overall mortality was 44%. Prognosis correlated with the admission Glasgow coma scale, severity of IVH, number of ventricles filled with blood, and presence of acute hydrocephalus. Conclusions: We concluded that IVH per se is not as serious as it was presented in earlier studies compared with other types of intracranial hemorrhages, and it seldom has a major effect on the neurological outcome.