J Korean Med Sci.  2021 Jan;36(1):e4. 10.3346/jkms.2021.36.e4.

Comparative Analysis of the Patients with Spontaneous Thalamic Hemorrhage with Concurrent Intraventricular Hemorrhage and Those without Intraventricular Hemorrhage

• Nam TM
• Jang JH
• Kim SH
• Kim KH
• Kim YZ

• KMID: 2510384
• DOI: http://doi.org/10.3346/jkms.2021.36.e4

Abstract

Background
This study aimed to compare the characteristics of patients with spontaneous thalamic hemorrhage (STH) accompanied by intraventricular hemorrhage (IVH) with those of patients without IVH.
Methods
The medical records of consecutive patients with STH admitted to our institute between January 2000 and December 2018 were reviewed retrospectively. The laboratory and radiological results, mortality, and functional recovery were compared between the STH patients with IVH and those without IVH.
Results
Among 2,389 patients with spontaneous intracerebral hemorrhage, 233 (9.8%) patients were included in this study. Concurrent IVH was detected in 159 (68.2%) patients with STH, and more frequently in those with body mass index ≥ 25, Glasgow Coma Scale score of 3–8, underlying disease, family history of stoke, posterior/medial/global location of hematoma, ventriculomegaly, large volume of hemorrhage, and midline shift ≥ 5 mm. The 3-month mortality was 25.8% and 8.1% (P = 0.039), the rate of good functional recovery at 6 months was 52.2% and 31.0% (P = 0.040), and incidence of delayed normal pressure hydrocephalus (NPH) at 12 months was 10.8% and 24.5% (P = 0.062) in the STH patients with IVH and those without IVH, respectively. At 12 months, delayed NPH developed in 28 of 47 (59.6%) patients who received external ventricular drainage (EVD)-based treatment, 5 of 45 (11.1%) patients who underwent endoscopic evacuation-based treatment, and 8 of 45 (17.8%) patients who underwent other surgeries.
Conclusion
Concurrent IVH is strongly associated with mortality in patients with STH. Delayed NPH may develop more frequently in STH patients with IVH who were treated with EVD.

Keyword

Intraventricular Hemorrhage; Morbidity; Mortality; Normal Pressure Hydrocephalus; Outcome; Spontaneous Intracerebral Hemorrhage; Thalamus

Figure

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  Fig. 1 Cumulative incidence of delayed normal pressure hydrocephalus in 159 patients with spontaneous thalamic hemorrhage accompanied with intraventricular hemorrhage according to the treatment modalities.EVD = external ventricular drainage, Tx = treatment.

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