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Updated: Aug 13, 2026
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Morphoclinical study of intracerebral haemorrhage with intraventricular extension
B Zaharia1, I E Pleşea, C C Georgescu
1Department of Pathology, University of Medicine and Pharmacy of Craiova. zb@umfcv.ro
Insights
Severe intracerebral hemorrhage with intraventricular extension is often fatal, particularly in colder months. High blood pressure and low Glasgow scores significantly worsen outcomes, indicating poor prognosis despite treatment.
Area of Science:
- Neurology
- Pathology
- Radiology
Background:
- Intracerebral hemorrhage (ICH) with intraventricular extension (IVE) is a severe neurological emergency.
- Understanding associated clinical and morphological factors is crucial for prognosis.
Purpose of the Study:
- To conduct an integrated assessment of clinical, imaging, and morphological parameters in patients with severe ICH and IVE.
- To identify factors contributing to mortality in these patients.
Main Methods:
- Retrospective analysis of 93 deceased patients with ICH and IVE.
- Evaluation of clinical data (seasonality, age, sex, hypertension, Glasgow score, motor deficit) and morphological data (hematoma location/size, mass effect, edema, effusion) from CT scans and autopsies.
Main Results:
- IVE showed a predilection for cold seasons (autumn).
- Most patients were middle-aged, male, with severe hypertension, motor deficits, and low Glasgow scores (<6).
- Large hematomas, mass effect, and perilesional edema were consistently present.
Conclusions:
- The combination of IVE with hypertension, low Glasgow scores, large hematoma volume, and mass effect leads to high mortality.
- These factors indicate a poor prognosis, often overriding therapeutic interventions.
Aims:
The study is an integrated assessment of clinical, image and morphological parameters in severe intracerebral haemorrhages (ICH) complicated with intraventricular extension (IVE).
Material And Methods:
The studied group had 93 cases of patients with ICH and IVE who were hospitalized in the Emergency County Hospital of Craiova and died during hospitalization. The parameters evaluated were clinical (relation with the seasons, age, sex, arterial blood pressure, the motor deficit, degree of coma, Glasgow score at admission and medical care) and morphological (the sites of the intraparenchymal haematoma and IVE, the size of the intraparenchymal haematoma, the presence of the mass effect, perilesional oedema and subarachnoid effusion). The latter were assessed on CT films and during autopsy.
Results:
The presence of IVE as a complication of ICH showed a predilection for cold seasons, especially autumn. From the 93 studied cases 51 were men and 42, women. 52.6% of the patients were in the fifth and sixth life decade. Almost 80% of the patients had IIIrd stage arterial hypertension at admission, over 80% motor deficits and almost 60% Glasgow scores lower than 6. The ventricular effusion involved at least one of the lateral ventricles. The hematomas had huge dimensions as compared to hosting encephalic structures, in lobar sites involving more than one lobe. Other risk factors as mass effect and perilesional oedema were constantly present.
Conclusions:
The association of IVE with other independent risk factors such as hypertension, low Glasgow scores volume of intraventricular bleeding, dimensions of haemorrhagic foci, presence of mass effect and perilesional oedema results in the death of patient despite any sustained therapeutic intervention.
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