SAN DIEGO—Patients with intraventricular hemorrhage after intracerebral hemorrhage have an increased risk for normal pressure hydrocephalus-like symptoms of urinary incontinence and dysmobility, researchers reported at the 2014 International Stroke Conference.
“This [finding] may explain the worse long-term outcomes of patients who survive intracerebral hemorrhage with intraventricular hemorrhage than of those who had intracerebral hemorrhage alone,” stated Daniel Woo, MD, Professor of Neurology, University of Cincinnati Department of Neurology and Rehabilitation Medicine, and colleagues.
The researchers analyzed data for patients who had enrolled in the Genetic and Environmental Risk Factors for Hemorrhagic Stroke Study between July 2008 and December 2012. The study authors reviewed CT images for intracerebral hemorrhage volume and location, as well as intraventricular hemorrhage presence and volume. Incontinence and dysmobility were defined according to the Barthel Index score at three-month follow-up interviews. A Barthel Index score regarding bladder of less than 10 defined incontinence, and a Barthel Index score regarding mobility of less than 15 defined dysmobility. The investigators used multivariate analysis to assess independent risk factors for incontinence and dysmobility.
A total of 308 patients had intracerebral hemorrhage, and 106 (34.4%) of this group had intraventricular hemorrhage. The presence of intraventricular hemorrhage was independently associated with incontinence (odds ratio [OR], 2.7) and dysmobility (OR, 2.5), according to the researchers.
“Increasing intraventricular hemorrhage volume was independently associated with incontinence and dysmobility even after controlling for intracerebral hemorrhage location, intracerebral hemorrhage volume, age, baseline modified Rankin Scale score, and admission Glasgow Coma Scale score,” Dr. Woo and colleagues stated.
“Future studies are needed to confirm this finding and to determine the effect of intraventricular hemorrhage interventions such as shunt or intraventricular thrombolysis on reducing disability long term as well as their short-term benefits related to intracranial pressure,” the researchers concluded.