Department of Neurosurgery, University of Maryland, Baltimore, MD, USA.
Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
J Intensive Care Med. 2024 Sep;39(9):813-819. doi: 10.1177/08850666231204582. Epub 2023 Sep 28.
Intraventricular hemorrhage (IVH) is a clinical challenge observed among 40-45% of intracerebral hemorrhage (ICH) cases. IVH can be classified according to the source of the hemorrhage into primary and secondary IVH. Primary intraventricular hemorrhage (PIVH), unlike secondary IVH, involves only the ventricles with no hemorrhagic parenchymal source. Several risk factors of PIVH were reported which include hypertension, smoking, age, and excessive alcohol consumption. IVH is associated with high mortality and morbidity and several prognostic factors were identified such as IVH volume, number of ventricles with blood, involvement of fourth ventricle, baseline Glasgow Coma Scale score, and hydrocephalus. Prompt management of patients with IVH is required to stabilize the clinical status of patients upon admission. Nevertheless, further advanced management is crucial to reduce the morbidity and mortality associated with intraventricular bleeding. Recent treatments showed promising outcomes in the management of IVH patients such as intraventricular anti-inflammatory drugs, lumbar drainage, and endoscopic evacuation of IVH, however, their safety and efficacy are still in question. This literature review presents the epidemiology, physiopathology, risk factors, and outcomes of IVH in adults with an emphasis on recent treatment options.
脑室内出血（IVH）是在 40-45%的脑出血（ICH）病例中观察到的临床挑战。IVH 可以根据出血来源分为原发性和继发性 IVH。与继发性 IVH 不同，原发性脑室内出血（PIVH）仅涉及脑室，没有出血性实质来源。据报道，PIVH 的几个危险因素包括高血压、吸烟、年龄和过度饮酒。IVH 与高死亡率和高发病率相关，已经确定了几个预后因素，例如 IVH 体积、有血液的脑室数量、第四脑室受累、基线格拉斯哥昏迷评分和脑积水。需要及时对 IVH 患者进行管理，以稳定患者入院时的临床状况。然而，进一步的先进管理对于降低与脑室内出血相关的发病率和死亡率至关重要。最近的治疗方法在 IVH 患者的治疗中显示出有希望的结果，例如脑室内抗炎药物、腰椎引流和 IVH 的内镜清除，但它们的安全性和疗效仍存在疑问。本文献综述介绍了成人 IVH 的流行病学、病理生理学、危险因素和结果，重点介绍了最近的治疗选择。
