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Updated: May 27, 2026
Intracranial Pressure Monitoring In Nontraumatic Intraventricular Hemorrhage Rodent Model
Published on: February 8, 2022
Evaluation of intraventricular hemorrhage in pediatric intracerebral hemorrhage
Jonathan T Kleinman1, Lauren A Beslow, Kyle Engelmann
1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Insights
Detailed assessment of intraventricular hemorrhage in children with intracerebral hemorrhage did not independently predict outcomes. However, combined hemorrhage volume showed a trend toward improved prediction, suggesting further investigation is warranted.
Area of Science:
- Pediatric Neurology
- Neurocritical Care
- Pediatric Neurosurgery
Background:
- Pediatric intracerebral hemorrhage (PICH) studies have primarily focused on intraparenchymal hemorrhage (IPH).
- The prognostic value of intraventricular hemorrhage (IVH) in PICH requires further elucidation.
Purpose of the Study:
- To determine if detailed assessment of IVH enhances outcome prediction in children with PICH.
- To evaluate the association between IVH characteristics and clinical outcomes.
Main Methods:
- Prospective enrollment of 46 pediatric patients (full-term to 17 years) with spontaneous IPH and/or IVH.
- Outcome assessment using the King's Outcome Scale for Childhood Head Injury (KOSCHI).
- Analysis of IPH and IVH volumes, presence of IVH, and development of hydrocephalus.
Main Results:
- 57% had IPH, 22% had pure IVH, and 22% had both IPH and IVH.
- Two deaths occurred, both in patients with significant IPH and IVH (≥4% total brain volume).
- IVH presence was not a significant outcome predictor, but hydrocephalus showed a trend toward poor outcomes (P = .09). Combined IPH and IVH volume demonstrated a trend for better outcome prediction than IPH alone.
Conclusions:
- While IVH presence alone is not an independent predictor of outcome in pediatric intracerebral hemorrhage, its quantitative assessment alongside IPH may improve prognostic accuracy.
- Hydrocephalus is a potential factor influencing outcomes in pediatric patients with intracerebral hemorrhage.
- Further research is recommended to explore the qualitative and quantitative impact of IVH on pediatric intracerebral hemorrhage outcomes.
Abstract:
Previous studies of pediatric intracerebral hemorrhage have investigated isolated intraparenchymal hemorrhage. The authors investigated whether detailed assessment of intraventricular hemorrhage enhanced outcome prediction after intracerebral hemorrhage. They prospectively enrolled 46 children, full-term to 17 years, median age 2.7 years, with spontaneous intraparenchymal hemorrhage and/or intraventricular hemorrhage. Outcome was assessed with the King's Outcome Scale for Childhood Head Injury. Twenty-six (57%) had intraparenchymal hemorrhage, 10 (22%) had pure intraventricular hemorrhage, and 10 (22%) had both. There were 2 deaths, both with intraparenchymal hemorrhage and intraventricular hemorrhage volume ≥4% of total brain volume. Presence of intraventricular hemorrhage was not associated with poor outcome, but hydrocephalus showed a trend (P = .09) toward poor outcome. In receiver operating characteristic curve analysis, combined intraparenchymal hemorrhage and intraventricular hemorrhage volume also showed a trend toward better outcome prediction than intraparenchymal hemorrhage volume alone. Although not an independent outcome predictor, future studies should assess intraventricular hemorrhage qualitatively and quantitatively.
