Abstract Details

Title Risk Factors and Early Mortality Determine the Rate of Angiographic Testing in Primary Intraventricular Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 028

Objective

Background BACKGROUND: Primary intraventricular hemorrhage (PIVH) is an uncommon neurological vascular event associated with significant morbidity. The current literature describes two types of PIVH: 1) blood restricted to the ventricular system only 2) predominant IVH plus a small parenchymal component. About half of the PIVH patients undergo a diagnostic cerebral angiogram.

Design/Methods DESIGN/METHODS: A retrospective chart review was performed for all the intracerebral hemorrhage patients admitted to our institution over the last 3 years. Neuroradiology reports of initial CT scans were reviewed to capture patients. All CT scan images were reviewed and patients with PIVH were selected. Exclusion criteria included presence of subarachnoid hemorrhage and head trauma.

Results RESULTS: Out of 846 patients with intracerebral hemorrhage, 51 patients (6%) with PIVH were identified. Angiograms were not performed on 29 patients (56.8%). Patients who were not evaluated with an angiogram were significantly older (with median age 73 vs 51 years, p<0.01), higher past history of hypertension (100% vs 63.6%, p<0.01), greater chance of pre-admission anticoagulant or coagulopathy (34.5% vs 9.1%, p=0.048), lower rate of diagnostic testing like MRI brain or MR cervical spine done (37.9% vs 81.8%, p<0.01 and 3.4% vs 27%, p=0.03, respectively), lower rate of tracheostomy (10.3% vs 36.3%, p=0.039), higher in-patient mortality (20.7% vs 0%, p=0.03) and shorter median length of hospital stay (11 vs 17 days, p=0.018).

Conclusions CONCLUSIONS: In patients with PIVH, older age, history of hypertension and presence of coagulopathy or anticoagulation determine the likelihood of diagnostic testing with cerebral angiogram. Higher inpatient mortality in those without angiogram may reflect a sicker population and overall less aggressive diagnostic approach.

Authors/Disclosures
Ather Taqui, MD (Novant Health Neurology Specialists) PRESENTER	No disclosure on file
Lauren Koffman, DO, MS (Temple University Hospital)	Dr. Koffman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Law Firm. Dr. Koffman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Walters Kluwer.
Muhammad S. Hussain, MD (Cleveland Clinic)	Dr. Hussain has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cerenovus. Dr. Hussain has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Tiger Medical.
Ken Uchino, MD (Cleveland Clinic Foundation)	Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aboott Laboratories, Inc.. Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ACP JOURNAL CLUB. The institution of Dr. Uchino has received research support from NIH.
Rohit Bakshi, MD, FAAN	Dr. Bakshi has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Bakshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. The institution of Dr. Bakshi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Neuroimaging. The institution of Dr. Bakshi has received research support from Bristol Myers Squibb. The institution of Dr. Bakshi has received research support from EMD Serono. The institution of Dr. Bakshi has received research support from Novartis.

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