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Ventricular Hemorrhage


Presentation

  • Moyamoya vessels were also present. He received bilateral encephalo-duro-arterio-myo-synangiosis with good results. Moyamoya disease may cause hemorrhage even at an early stage.[ncbi.nlm.nih.gov]
  • Clinical presentation of intraventricular hemorrhage (regardless of cause) is similar to that of subarachnoid hemorrhage. Patients experience sudden onset of severe headache 2 .[radiopaedia.org]
Italian
  • A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE[minervamedica.it]
Aspiration
  • INTRODUCTION: The Apollo system (Penumbra Inc, Alameda, California, USA) is a low profile irrigation-aspiration system designed for the evacuation of intracranial hemorrhage.[ncbi.nlm.nih.gov]
  • Multiple target aspiration technique for subacute stereotactic aspiration of hematomas within the basal ganglia . Surg Neurol 2003 ; 60 (1): 8 –13. 27. Tzaan WC , Lee ST , Lui TN .[cambridge.org]
Hypotension
  • The incidence of hypotension was 51 % in the Cochrane database review [ 16 ] versus 56 and 67 % in our population of newborns.[bmcpediatr.biomedcentral.com]
  • -Premature birth: Less than 34 weeks gestation, respiratory failure, requiring intubation/mechanical ventilation -Low apgars -Asphyxia -Low birth weight -Hypotension/hypertention -Low hematocrit -Rapid infusions of hyperosmolar solutions -Rapid fluid[quizlet.com]
  • Hypotension, hypothermia, metabolic acidosis, thrombocytopenia.[lecturio.com]
  • MRI is increasingly used to assess brain injury and its consequences on brain development. [ 6 ] Management This is initially mainly supportive and may include the correction of anaemia, acidosis and hypotension.[patient.info]
Cardiomegaly
  • Keywords provided by University of Utah: Omaya reservoirs cerebral oxygenation VP shunt IVH post hemorrhagic ventricular dilation (PVHD) Additional relevant MeSH terms: Layout table for MeSH terms Hemorrhage Dilatation, Pathologic Cerebral Hemorrhage Cardiomegaly[clinicaltrials.gov]
Stupor
  • The third patient with a left thalamic and basal ganglia hemorrhage, who was initially awake and then lapsed into stupor days later, underwent surgery, but did not recover consciousness.[ncbi.nlm.nih.gov]
  • Infants with severe intraventricular hemorrhage might develop metabolic or respiratory acidosis, apnea, hypotonia and stupor. The newborn might go into a coma.[lecturio.com]
  • There is a change in level of alertness (either stupor or an irritable, hyperalert state). A clue to the occurrence of IVH may be a falling hematocrit or failure of the hematocrit to rise after transfusion.[utmb.edu]
  • Symptoms can include: Abnormal sense of taste Change in alertness (level of consciousness) Apathetic, withdrawn Sleepy, lethargic, stuporous Unconscious, comatose Difficulty speaking or understanding speech Difficulty swallowing Difficulty writing or[snc.md]
Basal Ganglia Hemorrhage
  • Another patient with a large right basal ganglia hemorrhage who also underwent surgery on an emergency basis retained a spastic left hemiparesis without evident psychomotor deficits.[ncbi.nlm.nih.gov]
  • ganglia hemorrhage (common) lobar hemorrhage subarachnoid hemorrhage trauma CT Non contrast CT of the brain is the mainstay of acute evaluation of patients presenting to with sudden onset headache or stroke-like symptoms.[radiopaedia.org]
  • Influence of intraventricular fibrinolytic therapy with rt-PA on the long-term outcome of treated patients with spontaneous basal ganglia hemorrhage: a case–control study. Eur J Neurol, 15 (2008), pp. 342-349 [5] P. Nyquist, D. Hanley.[medintensiva.org]
Hyperreflexia
  • He had hyperreflexia of the left extremities and paresthesia of the left upper extremity. Angiography showed marked progression of the vascular abnormalities bilaterally. Moyamoya vessels were also present.[ncbi.nlm.nih.gov]
Opisthotonus
  • The second presented 6 days after birth with irritability, opisthotonus, a tense fontanelle and tonic seizures. The third was admitted three days after birth with seizures and a tense fontanelle.[ncbi.nlm.nih.gov]

Workup

  • Diagnostic Workup for Intraventricular Hemorrhage in Premature Newborns Laboratory investigations are rarely useful in infants with intraventricular hemorrhage unless the hemorrhage is severe enough to cause metabolic acidosis or respiratory acidosis.[lecturio.com]
  • Author Contributions CS, CG, CL, EG, AK, CM, and DH were involved with the workup and clinical care of the patient.[journal.frontiersin.org]
  • These results underscore the need of cerebral angiography and workup for coagulopathies in patients with PIVH. No definite cause was identified in seven (47%) patients and PIVH was assumed to be secondary to hypertension in 6 of these.[jpma.org.pk]

Treatment

  • We investigated the feasibility and safety of IVF followed by early LD for the treatment of posthemorrhagic hydrocephalus.[ncbi.nlm.nih.gov]
  • Placement in dominant IVH cast or multiple EVDs increases efficiency and treatment benefit. “Further investigation of EVD use, alteplase treatment goals, and ICP control measures are imperative,” they concluded. More ISC 2016 coverage here .[thecardiologyadvisor.com]
  • Although external ventricular drainage placement is an intuitive treatment for obstructive hydrocephalus this treatment does not address in total the aforementioned pathophysiological mechanisms underlying secondary brain damage.[minervamedica.it]

Prognosis

  • […] an analysis to be made of the prognosis and the risk factors associated with mortality.[medintensiva.org]
  • Prognosis Prognosis of intraventricular hemorrhage basically depends on many factors. The amount of lost blood, the type of damage to the nearby brain cells, the overall health of the affected individuals, comorbidities etc.[ic.steadyhealth.com]
  • Cerebellar hemorrhage is rare, associated with poor prognosis and is seen as an echogenic area within the cerebellum with non-visualization of the 4th ventricle.[sonoworld.com]
  • The ICH score, the most widely used and validated clinical grading scale for ICH since its publication in 2001, specifically incorporates the presence of intraventricular blood as a factor contributing to poorer prognosis ( 8 ).[journal.frontiersin.org]

Etiology

  • There are numerous causes of intraventricular hemorrhage and as such no single demographic can be identified; rather each underlying etiology contributes its own patient population.[radiopaedia.org]
  • The etiologies of the studied fourth IVH include hypertensive intracranial hemorrhage(39 cases), spontaneous subarachnoid hemorrhage(12 cases), primary IVH(9 cases), trauma(4 cases), Moyamoya disease(1 case).[jkns.or.kr]
  • Spontaneous primary intraventricular hemorrhage: clinical data, etiology, and outcome: J Neurol 1999;246:287-291. 2. Darby DG, Donnan GA, Saling MA, Walsh KW, Bladin PF.[neurologyindia.com]
  • Etiology and prognosis. Radiology 1982;143(1):91–96. PubMed Google Scholar 10. van Gijn J, Hijdra A, Wijdicks EF, Vermeulen M, van Crevel H. Acute hydrocephalus after aneurysmal subarachnoid hemorrhage. J Neurosurg 1985;63(3):355–362.[link.springer.com]
  • History of diabetes mellitus, coagulopathy as an underlying etiologic factor and presence of blood in all ventricles predict early mortality. However, our study is limited by its small sample size and retrospective nature.[jpma.org.pk]

Epidemiology

  • This text then examines the general principles of epidemiology. Other chapters consider the advantages and disadvantages of using autopsy data for epidemiologic studies.[books.google.com]
  • EPIDEMIOLOGY The overall incidence has decreased over the past decades as a result of improved perinatal care.[slideshare.net]
  • Epidemiology of Intraventricular Hemorrhage in Premature Newborns Image : “An intubated female premature infant born prematurely 26 weeks 6 days gestation, 990 grams. Photo taken at approximately 24 hours after birth.” by ceejayoz – .[lecturio.com]
Sex distribution
Age distribution

Pathophysiology

  • Ouellette have worked together to create a comprehensive reference that covers both the pathophysiology and epidemiology of problems occurring in premature babies in the Neonatal Intensive Care Unit, and the management of these problems once the infant[books.google.com]
  • Although external ventricular drainage placement is an intuitive treatment for obstructive hydrocephalus this treatment does not address in total the aforementioned pathophysiological mechanisms underlying secondary brain damage.[minervamedica.it]
  • Note that this classification is based on a radiologic appearance rather than a pathophysiologic description of events leading to GM/IVH.[emedicine.medscape.com]

Prevention

  • Injuries to the head, another cause of the aforementioned bleeding can also be sometimes prevented. Still, there is no definitive way of complete and utter prevention of such bleeding.[ic.steadyhealth.com]
  • How can intraventricular hemorrhage be prevented? There have been many prevention strategies investigated, both antenatal and postnatal, but none has been shown to be clearly effective.[clinicaladvisor.com]
  • Prevention of IVH Many trials and prevention strategies were based on the general theory that the incidence of IVH would decrease if episodes of cerebral blood flow fluctuations, hypoxia, hypercapnia, and increased venous pressure could be minimized in[ispn.guide]
  • PREVENTION ANTENATAL PREVENTION Avoid preterm delivery VIT k should be given before delivery to all women receiving phenobarbitone or phenytoin during pregnancy C section of high risk deliveries A single course of antenatal corticosteroids is recommended[slideshare.net]

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