Turkish Neurosurgery 2009 , Vol 19 , Num 4
Spontaneous Primary Intraventricular Hemorrhage in Adults: Clinical Data, Etiology and Outcome
Semih GIRAY1, Orhan SEN2, Fevzi Birol SARICA3, Kadir TUFAN4, Mehmet KARATAS5, Baflak KARAKURUM GOKSEL6, Deniz YERDELEN7, Melih CEKINMEZ8, Ufuk CAN9
1,5,6,7,9Baskent University, Department of Neurology, Ankara, Turkey
2,3,4,8Baskent University, Department of Neurosurgery, Ankara, Turkey
AIM: Primary intraventricular hemorrhage (PIVH), bleeding in the ventricular system without a recognizable parenchymal component, is a rare neurological disorder. The purpose of this study was to identify clinical features, risk factors, etiology and outcome of patients with PIVH.

MATERIAL and METHODS: We retrospectively reviewed the clinical data, complementary examinations, outcome and computed tomography (CT) IVH score of 24 patients in our hospital from 2004 to 2008. We identified 24 patients with the inclusion criteria of non-traumatic PIVH. Their mean age was 60.6▒17.4 years (range 38-79). Fourteen patients were male and 10 were female.

RESULTS: The major symptoms included headache (n=24), loss of consciousness (n=6), confusion and disorientation (n=14), nausea/vomiting (n=10). Angiography revealed vascular malformations in five patients (21%). Other possible causative factors were hypertension in 12 patients (50%) and clotting disorder in one. The aetiology remained unknown in six patients. Most PIVH patients had associated hydrocephalus (58%) and 37% of the patients required ventricular drainage. In-hospital mortality was high (41%) and a FOUR score ≤10, GCS ≤8 and early hydrocephalus were independent predictors of mortality.

CONCLUSION: Hypertension is the most common associated risk factor for PIVH followed by vascular malformation. Spontaneous resorption and rebleeding may be seen. The neurological status of the patients and an early developing hydrocephalus are the most important risk factors. Keywords : Primary intraventricular hemorrhage, Hypertension, Arteriovenous malformation, Hydrocephalus

Corresponding author : Semih Gřray, sgiray72@hotmail.com