抄録
The authors studied 22 cases of traumatic IVH encountered during a recent 5-year period, with particular emphasis on factors related to outcome. There were 21 males and one female ranging in age from 3 to 76 years. These 22 cases constituted 7.2% of all severe head injuries (Types III and IV, according to Araki's classification) seen in the authors' institution during the study period. They were classified into four types on the basis of the CT findings: Type I, IVH with no other intracranial abnormality; Type II, IVH with other intracranial abnormalities; Type III, delayed IVH (after decompressive surgery) ; and Type IV, IVH due to penetration of an intracerebral hematoma. The incidence of Types II and IV IVH was high. The average Glasgow Coma Scale (GCS) score on admission was 7.0, with Type I patients having the lowest mean score (4.3). The direction of impact was most often anteroposterior in Type I and lateral in Type II. Associated intracranial lesions were observed in 95% of the patients. These were mostly brainstem injury in Type I and brain contusion or subdural hematoma in Types II and III. The overall mortality rate was 54.5%. It was 67% in Type I, 50% in Type II, 33% in Type III, and 63% in Type IV. The outcome appeared to have been determined largely by the severity of associated brain injury and the GCS score, which suggests that the severity of impact or brain injury causing the IVH is the most important factor in terms of prognosis.
