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Hydrocephalus is an independent factor affecting morbidity and mortality of ICH patients: Systematic review and

Petra Octavian Perdana Wahjoepramono1,2, Aloysius Bagus Sasongko1,2, Danny Halim3,4

  • 1Department of Neurosurgery, Faculty of Medicine, Pelita Harapan University/Siloam Hospitals, Tangerang, Banten, Indonesia.

World Neurosurgery: X
|June 26, 2023
PubMed

Insights

Hydrocephalus significantly worsens outcomes for intracerebral hemorrhage (ICH) patients, increasing mortality and reducing functional recovery. Incorporating hydrocephalus (HC) into prognostication scores is crucial for better patient management.

Area of Science:

  • Neurology
  • Neurosurgery
  • Critical Care Medicine

Background:

  • Intracerebral hemorrhage (ICH) remains a leading cause of death and disability.
  • Intraventricular extension (IVH) is a known negative prognostic factor in ICH.
  • Hydrocephalus (HC), a complication of IVH, has not been consistently evaluated in ICH prognostication.

Purpose of the Study:

  • To evaluate the prognostic significance of hydrocephalus (HC) in patients with intracerebral hemorrhage (ICH).
  • To compare outcomes of ICH patients with and without IVH and HC through meta-analysis.

Main Methods:

  • Systematic literature search for studies comparing mortality/morbidity in ICH, ICH with IVH, and ICH with IVH and HC.
  • Meta-analysis using Mantel-Haenszel Risk Ratio at 95% significance.

Main Results:

  • ICH with IVH and HC showed significantly higher short-term (30-day) and long-term (90-day) mortality risks compared to ICH and ICH with IVH.
  • Patients with ICH, IVH, and HC had lower rates of good functional outcomes at 3 and 6 months.
  • Confounding factors included comorbidities, hemorrhage volume, midline shift, and low initial GCS score.

Conclusions:

  • Hydrocephalus is an independent negative prognostic factor in intracerebral hemorrhage.
  • Inclusion of hydrocephalus in prognostication scoring systems for ICH is recommended.
Abstract

Keywords:
Good functional outcomeHydrocephalusIntracerebral hemorrhageIntraventricular extensionMortalityStroke

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