Clinical Analysis of Prognostic Factors in Primary Intraventricular Hemorrhage

원발성 뇌실내 출혈의 예후 인자에 대한 임상적인 분석

Objective : This study was conducted to evaluate the prognostic factors of primary intraventricular hemorrhage. Methods : We retrospectively reviewed 26 patients who suffered from primary intraventricular hemorrhage between 2003 and 2007. We analyzed the various factors that might influence the prognosis and these included the patient age, the disease etiology, the initial Glasgow Coma Scale(GCS) score, the pupil reflex, Evan's ratio, Graeb' score, the ventriculocranial ratio (VCR) and dilatation of the fourth ventricle. The clinical outcomes were evaluated for each patient by using the Glasgow Outcome Scale (GOS) three months after the hemorrhage. Results : The overall mortality rate was 38.5%. The factors correlated with a poor clinical outcome are an initial GCS score below 12 (p<0.05), the absence of a pupil reflex (p<0.05), a Graeb' score above 9 (p<0.05), a VCR above 0.23 (p<0.05) and the presence of obstructive hydrocephalus (p<0.05). The etiology didn' influence the clinical outcome (p>0.05). Dilatation of the fourth ventricle showed a poor outcome in 10 patients (83.3%), but this was without clinical significance (p>0.05). Conclusion : A low initial GCS score, a high Graeb's score, the absence of a pupil reflex, a high VCR and the presence of obstructive hydrocephalus are associated with a poor outcome in patients with primary intraventricular hemorrhage.