• World Neurosurg · Apr 2019

    Clinical features and prognosis of primary intraventricular hemorrhage in the elderly: a single center experience.

    • Rui Guo, Ruiqi Chen, Zhiyuan Yu, Rui Tian, Yanming Ren, Chao You, and Lu Ma.
    • Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.
    • World Neurosurg. 2019 Apr 1; 124: e445e452e445-e452.

    ObjectivePrimary intraventricular hemorrhage (PIVH) is rare in the aging population and remains a challenge for cerebrovascular surgeons. In the present study, the authors reviewed the patient characteristics, angiographic results, and treatments and determined clinical outcomes in 34 patients older than 60 years of age who were treated at West China Hospital between 2010 and 2014.MethodsThe medical records of elderly patients were queried. The parameters regarding patient demographics, presenting symptoms, treatment modalities, angiographic results, and clinical outcomes were assessed and analyzed.ResultsThere were 19 male (55.9%) and 15 female (44.1%) patients, with an average age (±SD) of 67.9 ± 7.7 years in our study. The most common symptoms on presentation were headache (50%), followed by disturbance of consciousness (26.5%). Only 5 patients (14.3%) were diagnosed with underlying cerebrovascular etiologies including Moyamoya disease (5.9%), arteriovenous malformations (2.9%), and aneurysms (5.9%). Idiopathic PIVH was diagnosed in 29 patients (85.7%). Thirteen patients (38.2%) underwent surgical intervention, while 21 patients (61.8%) received conservative treatment. Twelve patients (35.3%) had an unfavorable outcome at discharge, and an unfavorable outcome was observed in 14 patients (41.2%) at the 3-month follow-up. Patients with higher Graeb score might be associated with an unfavorable outcome both in short-term and long-term follow-up.ConclusionsMost PIVH patients were diagnosed with idiopathic PIVH in the elderly. Surgical treatment of aging patients should be optimized to improve clinical outcomes. The admission Graeb scores were considered to be the independent prognostic factors for both short-term and long-term outcomes.Copyright © 2018 Elsevier Inc. All rights reserved.

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