The Analysis of Prognostic Factors of IVH with EVD Treatment

ABSTRACT

The author analyzed retrospectively 94 cases of spontaneous intraventricular hemorrhage(IVH) which were treated with external ventricular drainage(EVD) at the Department of Neurosurgery. Chungnam National University Hospital from January 1990 to June 1994. In all cases, infusion of urokinase was attemped for effective drainage. The peak age group of IVH patients were those in their sixth decade, but in primary IVH, younger patients were more frequently affected. The order of causes of primary IVH are hypertension, arteriovenous malformation, Moyamoya disease, and cerebral aneurysm, however, secondary IVH are mostly associated with hypertension and aneurysm. The overall mortality rate was 38%. A low initial Glasgow coma scale(under 5)(p<0.01), a high Graeb score(over 10)(p=0.001), fourth ventricular hemorrhagic dilation(p=0.001), secondary IVH(p=0.009), unilateral or bilateral pupil fixation at the preoperative stage(p<0.001) and long duration of EVD(p=0.045) are all poor prognostic factors associated with higher mortality.