Hémorragies intraventriculaires secondaires à la rupture d’un angiome cérébral : description, suivis et impact de la fibrinolyse

Abstract

Introduction Arteriovenous malformation (AVM) rupture could lead to intraventricular hemorrhage (IVH), a particularly severe form of intracranial bleeding. The epidemiology, presentation, management and outcomes of IVH related to AVM rupture have not been clearly addressed yet. The aim of the present study was to investigate the characteristics of IVH related to AVM rupture, with particular attention paid to functional outcomes and to the impact of intraventricular fibrinolysis (IVF). Material Between 2011 and 2015, all patients suffering from IVH admitted in two tertiary neurosurgical centers were included in a prospective register. Patient with IVH related to AVM rupture were identified (n = 29) and their data retrospectively collected. Particular attention was paid on patients who received IVF. We also compared them to 29 apparied aneurysmal IVH. Results IVH related to AVM rupture often occurred in young patients. In most cases, intracerebral hemorrhage was associated to IVH. Overall, 17.2% of the patients died and functional outcome at 6 months was similar to those with aneurysmal IVH, with a mean modified Rankin scale of 2.5. Interestingly, 5 patients received IVF and none experienced any rebleeding. Conclusion IVH related to AVM rupture is a severe form of hemorrhagic stroke, with a poor neurologic prognosis. IVF seems to be safe and may be considered in this particular form of IVH.