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Traumatic intraventricular haemorrhage
1Department of Emergency Medicine, Kawasaki Medical School, Okayama, Japan.
Insights
This study on traumatic intraventricular hemorrhage in 19 patients found blood in various ventricle locations. Co-existing intracranial lesions significantly impacted patient outcomes, despite some good recoveries.
Area of Science:
- Neurology
- Radiology
- Trauma Surgery
Background:
- Traumatic intraventricular hemorrhage (IVH) is a severe complication of head injury.
- Understanding the patterns and clinical significance of IVH is crucial for patient management.
Purpose of the Study:
- To analyze the clinical features and computerized tomography (CT) findings in patients with traumatic IVH.
- To correlate CT findings with patient outcomes and identify factors influencing recovery.
Main Methods:
- Retrospective analysis of 19 patients with traumatic IVH.
- Review of clinical data, including Glasgow Coma Scale (GCS) scores and Glasgow Outcome Scale (GOS).
- Detailed examination of CT scans to determine the location and extent of intraventricular blood and associated intracranial lesions.
Main Results:
- The most common sites for intraventricular hemorrhage were the occipital horn (8 patients) and around the foramen of Monro (6 patients).
- Hemorrhage near the foramen of Monro was associated with contusion of the corpus callosum, septum pellucidum, and fornix.
- A high incidence of co-existing intracranial lesions (17 patients) and extracranial lesions (13 patients) was observed.
- While GCS and GOS scores were generally unfavorable, 4 patients achieved good recovery.
Conclusions:
- The location of traumatic IVH varies, with the occipital horn and foramen of Monro being frequent sites.
- The presence and severity of associated intracranial injuries are critical determinants of patient prognosis in traumatic IVH.
- Despite the severity of injuries, some patients can achieve good recovery, highlighting the need for comprehensive management.
Abstract:
The findings of computerized tomography and clinical features were studied in 19 patients with traumatic intraventricular haemorrhage. Blood was found in various portion of the ventricles. Main sites of the blood was as follows: around the foramen of Monro, 6 patients; in the body and occipital horn of the lateral ventricle, 5 patients; solely in the occipital horn, 8 patients. The haemorrhage around the foramen of Monro, resulting from contusion of the ventral portion of the corpus callosum, septum pellucidum, and fornix, showed an interesting CT finding. Intracranial co-existing lesions were seen in 17 patients, and extracranial lesions were seen in 13 patients, suggesting the external force was excessive. Both the Glasgow coma scale scores on admission and Glasgow outcome scale were generally unfavourable, but 4 patients showed good recovery. The final outcome was mainly influenced by the severity of the co-existing intracranial lesions.