Angelopoulos M, Gupta S R, Azat Kia B
Department of Neurology, Loyola University Medical Center, Maywood, Illinois, USA.
Surg Neurol. 1995 Nov;44(5):433-6; discussion 437. doi: 10.1016/0090-3019(95)00261-8.
Nontraumatic primary intraventricular hemorrhage in adults is uncommon. The purpose of this study was to identify clinical features, risk factors, and outcome of primary intraventricular hemorrhage in adults.
We identified computed tomography scans for nontraumatic primary intraventricular hemorrhage performed between 1982 and 1993 at our institutions and reviewed medical records to determine clinical features, risk factors, and outcomes of these patients.
Of 14 cases studied, the onset of symptoms was acute in all and the most common symptom was headache (78%), followed by nausea/vomiting (71%), and mental status change (71%). Seizures as well as focal neurologic deficits were uncommon. The associated risk factors were hypertension in 7 cases, aneurysm or arteriovenous malformation in 5, coagulopathy in 1, and fibromuscular dysplasia in 1 case. Five patients died acutely, and all of the survivors returned to functional independence. The patients with lethargy, pupillary and extraocular movement abnormalities, quadriparesis, hydrocephalus, and aneurysmal intraventricular hemorrhage had worse outcomes.
Patients with nontraumatic primary intraventricular hemorrhage present with sudden onset of diffuse neurologic symptoms. The mortality in early phase is high (36%) and the prognosis for survivors is good. Factors correlating with the outcome are discussed.
成人非创伤性原发性脑室内出血并不常见。本研究旨在明确成人原发性脑室内出血的临床特征、危险因素及预后。
我们找出了1982年至1993年间在我们机构进行的非创伤性原发性脑室内出血的计算机断层扫描，并查阅病历以确定这些患者的临床特征、危险因素及预后。
在研究的14例病例中，所有患者症状均急性起病，最常见的症状是头痛（78%），其次是恶心/呕吐（71%）和精神状态改变（71%）。癫痫发作和局灶性神经功能缺损并不常见。相关危险因素包括7例高血压、5例动脉瘤或动静脉畸形、1例凝血功能障碍和1例纤维肌发育异常。5例患者急性死亡，所有幸存者恢复到功能独立。出现嗜睡、瞳孔和眼球运动异常、四肢瘫、脑积水和动脉瘤性脑室内出血的患者预后较差。
非创伤性原发性脑室内出血患者表现为突发弥漫性神经症状。早期死亡率较高（36%），幸存者预后良好。文中讨论了与预后相关的因素。
