• Edward Chan, Craig S Anderson, Xia Wang, Hisatomi Arima, Anubhav Saxena, Tom J Moullaali, Emma Heeley, Candice Delcourt, Guojun Wu, Jinchao Wang, Guofang Chen, Pablo M Lavados, Christian Stapf, Thompson Robinson, John Chalmers, Yining Huang, and INTERACT2 Investigators.
• From the George Institute for Global Health, Neurological and Mental Health Division, Royal Prince Alfred Hospital, Sydney, Australia (E.C., C.S.A., X.W., H.A., A.S., T.J.M., E.H., C.D., J.C.); Central Clinical School, University of Sydney, Sydney, Australia (E.C., C.S.A., X.W., H.A., A.S., E.H., C.D., J.C.); Department of Neurology, Hebei Yutian Hospital, Tangshan, China (G.W., J.W.); Department of Neurology, Xuzhou Central Hospital, Jiangsu, China (G.C.); Servicio de Neurología, Departamento de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile (P.M.L.); Department of Neurological Sciences, Universidad de Chile, Santiago, Chile (P.M.L.); Department of Neurology, APHP-Hôpital Lariboisière and DHU NeuroVasc Paris-Sorbonne, Université Paris Diderot-Sorbonne Paris Cité, Paris, France (C.S.); Department of Cardiovascular Sciences and NIHR Biomedical Research Unit in Cardiovascular Disease, University of Leicester, Leicester, United Kingdom (T.R.); and Department of Neurology, Peking University First Hospital, Beijing, China (Y.H.).
• Stroke. 2015 Mar 1; 46 (3): 653-8.

Background And PurposeIntraventricular hemorrhage (IVH) with spontaneous intracerebral hemorrhage indicates a poor prognosis but uncertainty exists over the pattern of association. We aimed to elucidate risk associations of IVH and outcome in the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2) data set.MethodsINTERACT2 was an international prospective, open-blinded end point, randomized controlled trial in 2839 patients with intracerebral hemorrhage (<6 hours) with elevated systolic blood pressure randomly assigned to intensive (target systolic blood pressure <140 mm Hg) or guideline-based (systolic blood pressure <180 mm Hg) blood pressure management. Associations of baseline IVH in 740 of 2613 (28%) patients and poor outcomes (death and major disability defined on the modified Rankin Scale) at 90 days were determined in linear and logistic regression models.ResultsPatients with IVH were significantly older and with greater neurological impairment, history of ischemic stroke, and larger hematomas more often deep hemisphere located at presentation, after adjustment for other baseline variables. Death or major disability occurred in 66% with IVH versus 49% in intracerebral hemorrhage-alone patients (adjusted odds ratio, 1.68; 95% confidence interval, 1.38-2.06; P<0.01). Associations of IVH volume and clinical outcomes were strong and near continuous. Adjusted analyses by thirds of IVH volume indicate thresholds of ≈5 and 10 mL for significantly increased odds of death and death or major disability, respectively.ConclusionsA strong association exists between the amount of IVH and poor outcome in intracerebral hemorrhage. An IVH volume of 5 to 10 mL emerges as a significant threshold for decision making on prognosis in these patients.Clinical Trial Registration Urlhttp://www.clinicaltrials.gov. Unique identifier: NCT00716079.© 2015 American Heart Association, Inc.

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