Comparative analysis of predictive significance of neuroimaging parameters in patients with spontaneous supratentorial intracerebral hemorrhage
DOI:
https://doi.org/10.14739/2310-1210.2018.4.137097Keywords:
cerebral hemorrhage, X-ray tomography, prognosisAbstract
The main purpose of the study was to conduct a comparative analysis of the neuroimaging parameters informative value for the determination of vital and functional outcomes prognosis of the spontaneous supratentorial intracerebral hemorrhage (SSICH) in the acute period, depending on the secondary intraventricular hemorrhage (SIVH) presence or absence at the disease onset.
Materials and methods. A prospective cohort study was conducted in 154 patients (88 men and 66 women, mean age 64.4 ± 0.9 years) with SSICH on the basis of conservative treatment. This study included clinical assessment and visualization of cerebral structures. Intracerebral hemorrhage volume (ICHV), average midline shift (AMS) and intraventricular hemorrhage volume (IVHV) were detected. The modified Rankin Scale (mRS) score >3 on the 21st day of the disease was considered as an unfavourable functional outcome of SSICH in the acute period.
Results. Secondary intraventricular hemorrhage was revealed in 70 (45.5 %) patients. It was found that ICHV was less informative than IVHV in patients with SIVH for the vital outcome prognosis of disease in the acute period determination (AUCICHV = 0.72 ± 0.09 (0.60–0.82) versus AUCIVHV = 0.94 ± 0.04 (0.86–0.98), P = 0.026), whereas the informative value of ICH volume and AMS were not significantly different in patients without SIVH for the vital outcome prognosis determination (AUCICHV = 0.77 ± 0.11 (0.67–0.86) versus AUCAMS = 0.87 ± 0.05 (0.78–0.94), P = 0.257) in the acute period of disease. It was detected, that IVHS >24.5 mL was the predictor of SSICH lethal outcome in the acute period (Se = 84.6 %, Sp = 96.5 %).
Conclusions. Predictive value of the neuroimaging parameters at SSICH onset depends on SIVH presence or absence. Intracerebral hemorrhage volume is less informative than IVHV and AMS for the vital and functional outcomes prognosis determination in the acute period of SSICH with SIVH. The informative value of neuroimaging parameters for the vital outcome prognosis of SSICH in the acute period determination is higher than the one for the functional prognosis determination.
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