Abstract
Primary intraventricular hemorrhage (PIVH) is rare, and causes, characteristics, and outcomes remain unknown in children. We retrospectively analyzed the clinical characteristics of patients 1 month to 21 years of age who were admitted to the hospital with PIVH over a 7-year period. PIVH was defined as bleeding confined to the ventricular system without parenchymal or subarachnoid hemorrhage involvement. Of 18 included patients, 55.6% were female, and mean age was 13.8 ± 6.0 years. The most common presenting symptoms were headache (77.8%) and vomiting (33.3%). In 15 patients (83.3%), known etiologies were diagnosed, including arteriovenous malformations (66.7%), moyamoya disease (11.1%), and aneurysms (5.6%). Idiopathic PIVH was the diagnosis in 3 patients (16.7%). Surgery was performed in 15 patients (83.3%), and 3 patients (16.7%) received conservative treatment. Four patients (28.6%) had an unfavorable outcome at discharge, and 3 patients (16.7%) had an unfavorable outcome at the 3-month follow-up. Higher Graeb score was associated with an unfavorable outcome in both short-term and long-term follow-up. Arteriovenous malformations were diagnosed in most pediatric patients with PIVH. Specific surgical treatment of underlying etiologies should be required to increase clinical improvement. Children with a higher Graeb score at admission tended to have poor early and late outcomes.
Highlights
Primary intraventricular hemorrhage is a rare type of stroke and little is known its causes, characteristics and outcomes in children
Most primary intraventricular hemorrhage patients were diagnosed with arteriovenous malformations in the pediatric population
According to preoperative Computed tomography angiography (CTA) or/and digital subtraction angiography (DSA) results, 15 patients (83.3%) were diagnosed with underlying vascular disorders, including arteriovenous malformation (AVM) in 12 patients (66.7%), Moyamoya disease in 2 patients (11.1%) and aneurysm in 61 patients (91.0%)
Summary
Primary intraventricular hemorrhage is a rare type of stroke and little is known its causes, characteristics and outcomes in children. Primary intraventricular hemorrhage (PIVH) is rare, constituting less than 9% of intracerebral hemorrhage (ICH).[1,2,3,4] PIVH is intraventricular hemorrhage with bleeding confined to the ventricular system.[1] The etiology of PIVH is complex, which can be caused by a variety of underlying vascular disorders.[5,6,7] the guidelines for PIVH management is absent. These conditions make this kind of hemorrhagic stroke a challenge for neurosurgeons and neurologists. Our study tried to explore the causes, clinical features, treatment and outcome of PIVH in the children
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