• Qi Li, Rui Li, Li-Bo Zhao, Xiao-Min Yang, Wen-Song Yang, Lan Deng, Xin-Ni Lv, Guo-Feng Wu, Zhou-Ping Tang, Miao Wei, Yi-Neng Zheng, Fa-Jin Lv, Xiao-Chuan Sun, Joshua N Goldstein, and Peng Xie.
• Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. qili_md@126.com.
• Neurocrit Care. 2020 Dec 1; 33 (3): 732-739.

Background/ObjectivesThe objective of this study is to propose a definition of intraventricular hemorrhage (IVH) growth and to investigate whether IVH growth is associated with ICH expansion and functional outcome.MethodsWe performed a prospective observational study of ICH patients between July 2011 and March 2017 in a tertiary hospital. Patients were included if they had a baseline CT scan within 6 h after onset of symptoms and a follow-up CT within 36 h. IVH growth was defined as either any newly occurring intraventricular bleeding on follow-up CT scan in patients without baseline IVH or an increase in IVH volume ≥ 1 mL on follow-up CT scan in patients with initial IVH. Poor outcome was defined as modified Rankin Scale score of 3-6 at 90 days. The association between IVH growth and functional outcome was assessed by using multivariable logistic regression analysis.ResultsIVH growth was observed in 59 (19.5%) of 303 patients. Patients with IVH growth had larger baseline hematoma volume, higher NIHSS score and lower GCS score than those without. Of 44 patients who had concurrent IVH growth and hematoma growth, 41 (93.2%) had poor functional outcome at 3-month follow-up. IVH growth (adjusted OR 4.15, 95% CI 1.31-13.20; P = 0.016) was an independent predictor of poor functional outcome (mRS 3-6) at 3 months in multivariable analysis.ConclusionIVH growth is not uncommon and independently predicts poor outcome in ICH patients. It may serve as a promising therapeutic target for intervention.

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