Tuhrim S, Horowitz D R, Sacher M, Godbold J H
Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA.
Crit Care Med. 1999 Mar;27(3):617-21. doi: 10.1097/00003246-199903000-00045.
To determine the prognostic significance and pathophysiologic implication of intraventricular extension of supratentorial intracerebral hemorrhage.
Prospective study.
Acute stroke and neurointensive care units of a tertiary care hospital.
One hundred twenty-nine patients with supratentorial intracerebral hemorrhage, managed medically.
Two patients had intraventricular catheters placed for external drainage. No patient received thrombolytics or surgical evacuation of clot.
Of the 129 patients, 47 had intraventricular extension of their hemorrhages. These patients had larger intraparenchymal hemorrhages (36.6 cm3 vs. 15.0 cm3) and lower initial Glasgow Coma Scale scores (mean, 9.6 vs. 13.7). Their 30-day mortality rate was 43% compared with only 9% among those without ventricular extension. Univariate and multivariate logistic regression modeling was used to assess the prognostic significance of various measures of intraventricular hemorrhage. The presence of intraventricular hemorrhage, the number of ventricles containing blood, fourth ventricular blood, and intraventricular hemorrhage volume were each related to 30-day mortality in a univariate analysis, but only intraventricular hemorrhage volume contributed significantly to outcome prediction in the presence of Glasgow Coma Scale score.
Volume of intraventricular hemorrhage is an important determinant of outcome in supratentorial intracerebral hemorrhage.
确定幕上脑出血脑室扩展的预后意义及病理生理影响。
前瞻性研究。
一家三级医疗医院的急性卒中与神经重症监护病房。
129例幕上脑出血患者，接受内科治疗。
2例患者放置脑室内导管进行外引流。无患者接受溶栓治疗或手术清除血凝块。
129例患者中，47例出现脑出血脑室扩展。这些患者脑实质内出血体积更大（36.6立方厘米对15.0立方厘米），初始格拉斯哥昏迷量表评分更低（平均9.6对13.7）。他们的30天死亡率为43%，而无脑室扩展患者的30天死亡率仅为9%。采用单因素和多因素逻辑回归模型评估脑室内出血各种指标的预后意义。在单因素分析中，脑室内出血的存在、含血脑室数量、第四脑室积血及脑室内出血量均与30天死亡率相关，但在存在格拉斯哥昏迷量表评分的情况下，仅脑室内出血量对结局预测有显著贡献。
脑室内出血量是幕上脑出血结局的重要决定因素。
