BACKGROUND AND PURPOSE: Previous studies have shown that the volume of intracerebral hemorrhage and Glasgow Coma Score (GCS) on admission are powerful predictors of 30-day mortality. However, the significance of hydrocephalus associated with deep cerebral hemorrhage has not been studied extensively. The purpose of this study was to determine the prognostic indicators of 30-day mortality in patients with deep cerebral hemorrhage. METHODS: We studied 100 consecutive patients with deep cerebral hemorrhage between 1994 and 1998. Deep cerebral hemorrhage was divided into 2 groups: putaminal hemorrhage (lateral group) and thalamic and caudate hemorrhage (medial group). Univariate and multivariate logistic regression analyses were performed to determine independent prognostic indicators of 30-day mortality. RESULTS: Hydrocephalus was present in 40 of the 100 patients. The 30-day mortality was 29%, and hydrocephalus was present in 76% of those who died. Multivariate analyses showed 2 independent prognostic indicators of 30-day mortality for putaminal hemorrhage: GCS </=8 (P:=0.002, odds ratio [OR] 37.7, CI 3.6 to 396.9) and hydrocephalus (P:=0.005, OR 27.4, CI 2.7 to 282.6). However, only GCS </=8 (P:=0.0002, OR 16.5, CI 3.7 to 73.4) was predictive of 30-day mortality for thalamic and caudate hemorrhage. This model (GCS </=8 and hydrocephalus) has a sensitivity of 57% and a specificity of 91% for predicting 30-day mortality for putaminal hemorrhage. When both attributes were present in putaminal hemorrhage (GCS </=8 and hydrocephalus), 1 (11%) of 9 patients survived, and when both attributes were missing 28 (100%) of 28 patients survived. CONCLUSIONS: Obstructive hydrocephalus on admission in a comatose patient with a putaminal hemorrhage predicts 30-day mortality.
BACKGROUND AND PURPOSE: Previous studies have shown that the volume of intracerebral hemorrhage and Glasgow Coma Score (GCS) on admission are powerful predictors of 30-day mortality. However, the significance of hydrocephalus associated with deep cerebral hemorrhage has not been studied extensively. The purpose of this study was to determine the prognostic indicators of 30-day mortality in patients with deep cerebral hemorrhage. METHODS: We studied 100 consecutive patients with deep cerebral hemorrhage between 1994 and 1998. Deep cerebral hemorrhage was divided into 2 groups: putaminal hemorrhage (lateral group) and thalamic and caudate hemorrhage (medial group). Univariate and multivariate logistic regression analyses were performed to determine independent prognostic indicators of 30-day mortality. RESULTS:Hydrocephalus was present in 40 of the 100 patients. The 30-day mortality was 29%, and hydrocephalus was present in 76% of those who died. Multivariate analyses showed 2 independent prognostic indicators of 30-day mortality for putaminal hemorrhage: GCS </=8 (P:=0.002, odds ratio [OR] 37.7, CI 3.6 to 396.9) and hydrocephalus (P:=0.005, OR 27.4, CI 2.7 to 282.6). However, only GCS </=8 (P:=0.0002, OR 16.5, CI 3.7 to 73.4) was predictive of 30-day mortality for thalamic and caudate hemorrhage. This model (GCS </=8 and hydrocephalus) has a sensitivity of 57% and a specificity of 91% for predicting 30-day mortality for putaminal hemorrhage. When both attributes were present in putaminal hemorrhage (GCS </=8 and hydrocephalus), 1 (11%) of 9 patients survived, and when both attributes were missing 28 (100%) of 28 patients survived. CONCLUSIONS: Obstructive hydrocephalus on admission in a comatosepatient with a putaminal hemorrhage predicts 30-day mortality.
Authors: Wendy C Ziai; Adrian R Parry-Jones; Carol B Thompson; Lauren H Sansing; Michael T Mullen; Santosh B Murthy; Andrew Mould; Saman Nekoovaght-Tak; Daniel F Hanley Journal: Biomolecules Date: 2021-07-30
Authors: Daniel B Herrick; Natalie Ullman; Saman Nekoovaght-Tak; Daniel F Hanley; Issam Awad; Shannon LeDroux; Carol B Thompson; Wendy C Ziai Journal: Neurocrit Care Date: 2014-12 Impact factor: 3.210
Authors: Jizong Zhao; Liangfu Zhou; Dingbiao Zhou; Renzhi Wang; Mei Wang; Dejiang Wang; Shuo Wang; Ge Yuan; Shuai Kang; Nan Ji; Yuanli Zhao; Xun Ye Journal: Front Med China Date: 2007-02-01
Authors: D B Zahuranec; N R Gonzales; D L Brown; L D Lisabeth; P J Longwell; S V Eden; M A Smith; N M Garcia; J T Hoff; L B Morgenstern Journal: J Neurol Neurosurg Psychiatry Date: 2006-03 Impact factor: 10.154