Wen-Song Yang1,2, Yi-Qing Shen1,2, Xiao-Dong Zhang3, Li-Bo Zhao4,5, Xiao Wei6, Xin Xiong7, Xiong-Fei Xie8, Rui Li1, Lan Deng1, Xin-Hui Li1, Xin-Ni Lv1, Fa-Jin Lv8, Qi Li9,10, Peng Xie11,12. 1. Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. 2. NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. 3. Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China. 4. Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China. 5. Chongqing Key Laboratory of Cerebrovascular Disease Research, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China. 6. Department of Medical Technology, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China. 7. Department of Neurology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, 400011, China. 8. Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. 9. Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. qili_md@126.com. 10. NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. qili_md@126.com. 11. Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. peng_xie@yahoo.com. 12. NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. peng_xie@yahoo.com.
Abstract
BACKGROUND/ OBJECTIVES: To propose a novel definition for hydrocephalus growth and to further describe the association between hydrocephalus growth and poor outcome among patients with intracerebral hemorrhage (ICH). METHODS: We analyzed consecutive patients who presented within 6 h after ICH ictus between July 2011 and June 2017. Follow-up CT scans were performed within 36 h after initial CT scans. The degree of hydrocephalus were evaluated by the hydrocephalus score of Diringer et al. The optimal increase of the hydrocephalus scores between initial and follow-up CT scan was estimated to define hydrocephalus growth. Poor long-term outcome was defined as a modified Rankin Scale of 4-6 at 3 months. Multivariate logistic regression analysis was performed to investigate the hydrocephalus growth for predicting 30-day mortality, 90-day mortality, and poor long-term outcome. RESULTS: A total of 321 patients with ICH were included in the study. Of 64 patients with hydrocephalus growth, 34 (53.1%) patients presented with both concurrent hematoma expansion and intraventricular hemorrhage (IVH) growth. After adjusting for potential confounding factors, hydrocephalus growth independently predicted 30-day mortality, 90-day mortality, and 90-day poor long-term outcome in multivariate logistic regression analysis. Hydrocephalus growth showed higher accuracy for predicting 30-day mortality, 90-day mortality, and poor long-term outcome than IVH growth or hematoma expansion, respectively. CONCLUSIONS: Hydrocephalus growth is defined by strongly predictive of short- or long-term mortality and poor outcome at 90 days, and might be a potential indicator for assisting clinicians for clinical decision-making.
BACKGROUND/ OBJECTIVES: To propose a novel definition for hydrocephalus growth and to further describe the association between hydrocephalus growth and poor outcome among patients with intracerebral hemorrhage (ICH). METHODS: We analyzed consecutive patients who presented within 6 h after ICH ictus between July 2011 and June 2017. Follow-up CT scans were performed within 36 h after initial CT scans. The degree of hydrocephalus were evaluated by the hydrocephalus score of Diringer et al. The optimal increase of the hydrocephalus scores between initial and follow-up CT scan was estimated to define hydrocephalus growth. Poor long-term outcome was defined as a modified Rankin Scale of 4-6 at 3 months. Multivariate logistic regression analysis was performed to investigate the hydrocephalus growth for predicting 30-day mortality, 90-day mortality, and poor long-term outcome. RESULTS: A total of 321 patients with ICH were included in the study. Of 64 patients with hydrocephalus growth, 34 (53.1%) patients presented with both concurrent hematoma expansion and intraventricular hemorrhage (IVH) growth. After adjusting for potential confounding factors, hydrocephalus growth independently predicted 30-day mortality, 90-day mortality, and 90-day poor long-term outcome in multivariate logistic regression analysis. Hydrocephalus growth showed higher accuracy for predicting 30-day mortality, 90-day mortality, and poor long-term outcome than IVH growth or hematoma expansion, respectively. CONCLUSIONS: Hydrocephalus growth is defined by strongly predictive of short- or long-term mortality and poor outcome at 90 days, and might be a potential indicator for assisting clinicians for clinical decision-making.
Authors: An N Massaro; Jennifer K Lee; Gilbert Vezina; Penny Glass; Alexandra O'Kane; Ruoying Li; Taeun Chang; Kenneth Brady; Rathinaswamy Govindan Journal: Neurocrit Care Date: 2020-11-20 Impact factor: 3.532
Authors: Vardan Nersesjan; Moshgan Amiri; Anne-Mette Lebech; Casper Roed; Helene Mens; Lene Russell; Lise Fonsmark; Marianne Berntsen; Sigurdur Thor Sigurdsson; Jonathan Carlsen; Annika Reynberg Langkilde; Pernille Martens; Eva Løbner Lund; Klaus Hansen; Bo Jespersen; Marie Norsker Folke; Per Meden; Anne-Mette Hejl; Christian Wamberg; Michael E Benros; Daniel Kondziella Journal: J Neurol Date: 2021-01-13 Impact factor: 4.849