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Intracerebral hemorrhage volume predicts poor neurologic outcome in children

Lori C Jordan1, Jonathan T Kleinman, Argye E Hillis

  • 1Department of Neurology, Division of Pediatric Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. Ljordan2@jhmi.edu

Stroke
|March 17, 2009
PubMed

Insights

Intracerebral hemorrhage (ICH) volume is a key predictor of neurological outcomes in children. Large hemorrhages, defined as >=4% of total brain volume, are associated with significantly worse outcomes.

Area of Science:

  • Pediatric Neurology
  • Neurocritical Care
  • Neuroradiology

Background:

  • Intracerebral hemorrhage (ICH) is a critical neurological event.
  • Predictors of outcome in pediatric ICH are less understood compared to adults.

Purpose of the Study:

  • To investigate the relationship between ICH volume and location with neurological outcomes in children.
  • To identify predictors of poor neurological outcomes in pediatric patients with acute ICH.

Main Methods:

  • Retrospective analysis of a cohort of pediatric patients (<18 years) with acute, non-traumatic ICH.
  • Hemorrhage volume calculated as a percentage of total brain volume (TBV); large hemorrhage defined as >=4% TBV.
  • Logistic regression used to identify predictors of poor neurological outcome (Glasgow Outcome Scale <=2).

Main Results:

  • Thirty children were included; median age was 6 years.
  • ICH volume >=4% of TBV independently predicted poor neurological outcome (OR, 22.5; P=0.03).
  • Hemorrhage location and intraventricular hemorrhage did not predict poor outcome in this cohort.

Conclusions:

  • ICH volume is a significant predictor of 30-day neurological outcome in children.
  • A hemorrhage volume of >=4% of TBV indicates a high risk for poor outcomes.
  • Findings can guide aggressive management strategies and prognosis counseling for pediatric ICH.
Abstract

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