[Prognostic significance of intraventricular hematoma in the cases of intracranial hemorrhage].

Fifty two patients with intracranial hemorrhage, which was diagnosed with CT scan, were reviewed in relation to the prognostic significance of the intraventricular hematoma. Following items were analyzed in each patient in order to classify the severity of the patients; cause of the hemorrhage, level of the consciousness at the time of evaluation, volume of the intraventricular hematoma, midline shift, cast formation of the intraventricular clots in the third and/or fourth ventricle and acute hydrocephalus. The total mortality rate of the patients analysed was 32.7%, whereas 42.3% of the patients returned to useful life. Level of the consciousness and cause of the hemorrhage were found most contributory factors to the prognosis, and, in general, the patients whose consciousness were better than in semicomatose state, could expect reasonably fair prognosis. When the level of consciousness was worse than semicoma, they were divided in two groups according to the cause of hemorrhage. Cases with ruptured intracranial aneurysm or hypertensive hemorrhage showed as a rule poor prognosis and, on the contrary, patients with AVM or MoyaMoya disease were not always poor in outcome. In the former group the level of consciousness was quite low and the prognosis was poor with higher mortality, if the intraventricular clot occupied over two third of the ventricles. However, cases with intraventricular clot caused by AVM stayed in good level of consciousness even the intraventricular hematoma extended into the all ventricles, and the prognosis was not pessimistic unless the AVM was unoperable. The midline shift on CT scan was well correlated with the high mortality in the cases of ruptured aneurysm.(ABSTRACT TRUNCATED AT 250 WORDS)