Giray Semih, Sen Orhan, Sarica Fevzi Birol, Tufan Kadir, Karatas Mehmet, Goksel Baflak Karakurum, Yerdelen Deniz, Cekinmez Melih, Can Ufuk
Baskent University, Department of Neurology, Ankara, Turkey.
Turk Neurosurg. 2009 Oct;19(4):338-44.
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.
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.
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 <or=10, GCS <or=8 and early hydrocephalus were independent predictors of mortality.
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.
原发性脑室出血（PIVH）是一种罕见的神经系统疾病，指脑室系统出血且无明显脑实质成分。本研究旨在确定PIVH患者的临床特征、危险因素、病因及预后。
我们回顾性分析了我院2004年至2008年24例患者的临床资料、辅助检查、预后及计算机断层扫描（CT）脑室出血评分。我们纳入了24例符合非创伤性PIVH纳入标准的患者。他们的平均年龄为60.6±17.4岁（范围38 - 79岁）。14例为男性，10例为女性。
主要症状包括头痛（n = 24）、意识丧失（n = 6）、意识模糊和定向障碍（n = 14）、恶心/呕吐（n = 10）。血管造影显示5例患者（21%）存在血管畸形。其他可能的病因包括12例患者（50%）患有高血压，1例患有凝血障碍。6例患者病因不明。大多数PIVH患者伴有脑积水（58%），37%的患者需要进行脑室引流。住院死亡率较高（41%），FOUR评分≤10、格拉斯哥昏迷量表（GCS）评分≤8以及早期脑积水是死亡的独立预测因素。
高血压是PIVH最常见的相关危险因素，其次是血管畸形。可能会出现自发吸收和再出血。患者的神经状态和早期发生的脑积水是最重要的危险因素。
