Non-Traumatic Primary Intraventricular Hemorrhage / 대한뇌혈관외과학회지

ABSTRACT

OBJECTIVE: Non-traumatic primary intraventricular hemorrhage (PIVH) in adults has rarely been reported. This study aimed to identify clinical features, risk factors, and neurological outcomes of PIVH in adults. METHODS: We retrospectively reviewed the clinical data, complementary examinations, outcomes, and computed tomography (CT) scans for non-traumatic PIVH occurring between 2002 and 2008 at our institutions. We defined PIVH as "a hematoma caused by non-traumatic factors, either confined completely within the ventricular system or arising within 15 mm of the ventricular wall." Result: Among the 19 PIVH patients treated in our institutions, the mean age was 55.5 years (range 19-81), and the male to female ratio was 0.72. Symptom onset was abrupt in 18 patients and progressive in 1. The most frequent complaint was headache (47%) followed by nausea and vomiting (38%). Seven patients (38%) had mental status impairment, ranging from stupor to semicoma. The causes of PIVH were unknown, although arteriography showed a suspicious vascular malformation in 1 patient. Seven (37%) patients died or entered a vegetative state. All survivors became functionally independent. No patients received ventriculoperitoneal shunts. Two of the surviving patients had limb weakness. Overall, 7 patients (37%) had GOS scores 1 to 2 and 12 (63%) had GOS scores 3 to 5. CONCLUSION: Although present technology allows clinicians to reach a diagnosis in many PIVH patients, the condition's etiology remains unknown, and its clinical manifestations vary, due to the rarity of these cases. Overall results and prognoses seem relatively better than in secondary intraventricular hemorrhage. However, evaluating and clarifying the nature of PIVH requires experience with more cases.