Intraventricular Hemorrhage After Head Injury: A Multicenter, Retrospective, Cohort Study

World Neurosurg. 2018 Jun:114:e350-e355. doi: 10.1016/j.wneu.2018.02.183. Epub 2018 Mar 9.

Abstract

Background: Data on traumatic intraventricular hemorrhage (IVH) are currently limited, and therefore, the condition is not fully understood. The aim of this study was to determine the epidemiology of traumatic IVH and its effects on outcome in patients with blunt head trauma.

Methods and materials: Using a nationwide trauma registry-the Japan Trauma Data Bank, we identified patients who underwent head computed tomography (CT) after blunt head trauma and had intracranial injuries between 2004 and 2015. The endpoint was in-hospital mortality. We compared patients with IVH and without IVH and adjusted for potential confounders using a multivariate logistic regression model.

Results: A total of 236,698 patients were registered in the database. Of the 139,058 patients who underwent head CT after blunt trauma, 906 (0.7%) had traumatic IVH. Among the 53,618 patients who were eligible for analysis, 871 had IVH. Traumatic IVH was associated with the occurrence of traffic accidents that caused trauma and severe injuries. Mortality was significantly higher in patients with IVH than in those without IVH (33.5% vs. 18.5%; P < 0.001); however, the difference was not significant after adjusting for confounding factors, with an adjusted odds ratio of 1.13 (95% confidence interval: 0.91-1.40).

Conclusions: Traumatic IVH is associated with a high mortality. However, the outcome in patients with traumatic IVH was worse than that in patients without IVH, which could be a result of factors associated with IVH rather than of IVH alone.

Keywords: Head injury; Intraventricular hemorrhage; Mortality; Prognosis; Trauma.

Publication types

  • Multicenter Study

MeSH terms

  • Accidents, Traffic / statistics & numerical data
  • Adult
  • Aged
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / etiology*
  • Cohort Studies
  • Craniocerebral Trauma / complications*
  • Craniocerebral Trauma / diagnostic imaging
  • Female
  • Glasgow Coma Scale
  • Humans
  • Male
  • Middle Aged
  • Tomography Scanners, X-Ray Computed