Future therapy in intracerebral hemorrhage and intraventricular hemorrhage: Aspiration and thrombolysis

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Introduction Thirty-day mortality after intracerebral hemorrhage (ICH) approaches 50%. Within the surviving patients, only 20% achieve a meaningful level of functional recovery at six months [1,2]. Intraventricular hemorrhage (IVH) is the direct hemorrhage of blood into the ventricles of the brain. Mortality estimates for IVH range from 50% to 80% [3–8]. The most common cause of IVH is spontaneous ICH, followed by subarachnoid hemorrhage (SAH). The incidence of IVH in ICH is about twice that in SAH [7]. Approximately 10% of aneurysmal SAH and 40% of primary ICH experience IVH [7,9,10]. Intraventricular hemorrhage in ICH and SAH account for 10% of the 700,000 strokes occurring yearly in the United States [7,9–11]. The total annual incidence of IVH in the United States is estimated to be about 22,000 adults per year [9]. Case-control cohort studies have repeatedly identified hematoma volume and admission Glasgow Coma Scale [GCS] score to be the main prognostic factors affecting survival and neurological outcome in patients with ICH and IVH [12]. Reduction of hematoma volume in both ICH and IVH could lead to improved neurological outcome by several mechanisms. Reduction of clot size will directly reduce local mass effect, thus decreasing the risk of fatal complications such as brainstem compression. In addition, minimizing hematoma volume could also lead to a decreased risk of globally elevated intracranial pressure (ICP) due to obstructive hydrocephalus (“trapped ventricles”).

Original languageEnglish (US)
Title of host publicationIntracerebral Hemorrhage
PublisherCambridge University Press
Pages176-186
Number of pages11
ISBN (Electronic)9780511691836
ISBN (Print)9780521873314
DOIs
StatePublished - Jan 1 2009

ASJC Scopus subject areas

  • Medicine(all)

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