Primary Intraventricular Haemorrhage: Clinical and Aetiological Profile with Predictors of Outcome-A Hospital Based Study OC01-OC04
Dr. Alak Pandit,
The Gateway, Tower-6, Flat-302, Unsani, Santragachi, Howrah-711302, West Bengal, India.
Introduction: Primary Intraventricular Haemorrhage (PIVH) is defined as bleeding in the ventricular system without a discernable parenchymal component or arising within 15 mm from the ventricular wall. PIVH is rare in clinical practice. Due to its rarity clinical and radiological factors affecting the outcome have not been widely studied.
Aim: To evaluate clinical features, aetiology and predictors of outcome in PIVH.
Materials and Methods: Forty patients with PIVH evaluated and treated at Bangur Institute of Neurosciences, Kolkata, West Bengal, India, from March 2015 to October 2016. PIVH was diagnosed as haemorrhage in the ventricles only, detected by Computed Tomography (CT) scan without evidence of intraparenchymal, Subarachnoid Haemorrhage (SAH), and Intraventricular Haemorrhage (IVH) associated with trauma. MR angiography was done in all patients as well as Digital Subtraction Angiography (DSA) was done in 34 patients. Categorical and continuous data were analysed using SPSS version 20.0.1.
Results: A total of (n=16, 40%) patients were females and (n=24, 60%) were males. Headache was the most common mode of presentation (n=12, 30%). Hypertension was the most common predisposing factor (n=24, 60%) followed by Arterio Venous Malformations (AVMs) (n=10, 25%), Moyamoya Disease (MMD), (n=8, 20%), aneurysm (n=5, 12.5%), vaso occlusive disease (n=4, 10%). Seven patients developed hydrocephalus and died, while the rest 33 survived. Aetiology remained unidentified in 10 patients.
Conclusion: Hypertension is an important predisposing factor in PIVH. Hydrocephalus is a common complication. There is a need for an appropriate work-up on patients with PIVH, as most cases are potentially treatable.