자발성 원발성 뇌실내 출혈환자의 예후 인자

Objective : A retrospective study is performed on 28 patients with primary intraventricular hemorrhage(PIVH) to examine the outcome and prognostic factors associated with this disorder.<BR> Methods : Clinical data collected between 1998 and 2002 was used in the present study. The outcomes of these patients were compared by age, etiology, initial Glasgow Coma Score(GCS), Graeb`s score, ventriculocranial ratio(VCR), hemorrhagic dilation of the third ventricle, and hemorrhagic dilation of the fourth ventricle. The Glasgow Outcome Scale(GOS) at discharge was used for the comparison of outcomes.<BR> Results : The mean age of these patients was 48.4±17.4 years. The underlying causes of PIVH were hypertension (53.6%), moyamoya disease(17.9%), arteriovenous malformation (10.7%), cerebral aneurysm (7.1%), and unknown (10.7%). The age and etiology were not correlated with outcome. Patients with a GCS of 13-15 showed a good outcome in 90.5%(p＜0.05). Those with a higher VCR (≥0.23) showed a poor outcome in 64.3%(p＜0.05). Patients with a Graeb`s score of 9-12 showed a poor outcome in 87.5%(p＜0.05). Those with hemorrhagic dilatation of the third ventricle showed a poor outcome in 80.0%, and those with hemorrhagic dilatation of the fourth ventricle showed a poor outcome in 85.7% (p＜0.05). The overall mortality rate was 17.9%.<BR> Conclusion : Low initial GCS, high Graeb`s score, high VCR, and hemorrhagic dilatation of the third ventricle or the fourth ventricle are correlated with poor outcome in PIVH.