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67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Severe intraventricular hemorrhage strongly predicts early complications and poor outcome after aneurysmal subarachnoid hemorrhage

Meeting Abstract

  • Marvin Darkwah Oppong - Klinik für Neurochirurgie, Universitätsklinikum Essen, Germany
  • Philipp Dammann - Klinik für Neurochirurgie, Universitätsklinikum Essen, Germany
  • Nicolai El Hindy - Klinik für Neurochirurgie, Universitätsklinikum Essen, Germany
  • Oliver Müller - Klinik für Neurochirurgie, Universitätsklinikum Essen, Germany
  • Ulrich Sure - Klinik für Neurochirurgie, Universitätsklinikum Essen, Germany
  • Ramazan Jabbarli - Klinik für Neurochirurgie, Universitätsklinikum Essen, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMO.09.06

doi: 10.3205/16dgnc037, urn:nbn:de:0183-16dgnc0377

Veröffentlicht: 8. Juni 2016

© 2016 Oppong et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Along with subarachnoid hemorrhage (SAH), aneurysm rupture can also cause intraventricular hemorrhage (IVH). In non-SAH cohorts, severe IVH is associated with certain complications and poor outcome. We aimed at identifying the risk factors and clinical impact of severe aneurysmal IVH.

Method: 805 consecutive SAH patients treated at our center between January 2003 and April 2014 were retrospectively analyzed. The severity of IVH was assessed using the original Graeb score upon admission computed tomography scan. The cases with Graeb-score>9 were attributed to severe IVH.

Results: IVH was present in 358 cases (44.5%). Severe IVH was observed in 77 patients (9.6%) and was significantly associated with the rupture of anterior cerebral artery aneurysms (p<0.0001, odds ratio (OR)=2.83), as well as larger aneurysm size (9.6 mm versus 7.1 mm, p= 0.0062). Patients with severe IVH presented frequently with poor initial clinical condition (World Federation Neurosurgical Societies Grade 5, p<0.0001, OR=3.25) and developed complications at the onset of SAH: cerebral infarction (p=0.0048, OR=2.1) and need for decompressive craniectomy (P<0.0001, OR=6.20). Contrarily, delayed complications (symptomatic vasospasm, meningitis and shunt dependency) were not more common for the patients with severe IVH. In-hospital mortality (p<0.0001) and unfavorable outcome at 6 months after SAH (defined as modified Rankin scale>3, p<0.0001) were strongly associated with severe IVH.

Conclusions: Location and size of the ruptured aneurysm are the key risk factors of severe IVH. The clinical impact of severe IVH is attributed to early brain injury with subsequent early complications.