Review of Primary Intraventricular Hemorrhage Reveals Dichotomous Outcomes (P3.089)

Background: Isolated primary intraventricular hemorrhage (PIVH) is rare. Typical course, causes, complications and outcomes have not been well established. Methods: Consecutive patient records with a diagnosis of intracranial hemorrhage (ICH) admitted from May 2009 to June 2014 at a tertiary care center were retrospectively reviewed. Patients with intraparenchymal, subarachnoid or subdural hemorrhage, malignancy with hemorrhage, or hemorrhagic conversion of ischemic stroke were excluded. Two neurologists reviewed the medical record, imaging reports, and imaging. Subjects were included if consensus was that subjects had PIVH. Results: We reviewed 1692 cases, 34 were determined to be PIVH. Fourteen (41[percnt]) were male; mean age of 57.7 years (range 20-88 years); average length of stay was 11 days. Presentation varied, including decreased level of consciousness (LOC) (17, 50[percnt]) and headache (11, 32[percnt]). Twenty-five (74[percnt]) had CT-angiogram, while cerebral angiography and MRI were each used in 16 (47[percnt]). Seventeen (50[percnt]) required an extra-ventricular drain; 8 (24[percnt]) required ventricular peritoneal shunt prior to discharge. Hypertension was a factor in 12 (35[percnt]). Coagulopathy was a factor in 7 (21[percnt]). Seven (21[percnt]) were cryptogenic. Vascular abnormalities (arteriovenous malformation, aneurysm and cavernoma) were found in 6 (18[percnt]). For outcomes, 6 (18[percnt]) expired, 11 (32[percnt]) were discharged to acute rehab (AR), 10 (30[percnt]) were discharged home, 4 (12[percnt]) were discharged to sub-acute nursing facility, 2 (6[percnt]) to long term care facility, and 1 (3[percnt]) to hospice. In total, 21 (62[percnt]) had a good outcome (discharged home or AR), while 7 (21[percnt]) died or entered hospice. Conclusion: PIVH is rare, with high morbidity and mortality, though in our study, a substantial percentage had a good outcome. Decreased LOC was the most common presentation. Hypertension was the most common contributing factor, followed by coagulopathy. Vascular lesions were less common than expected. More research is needed to fully understand this rare disease entity. Disclosure: Dr. Sirdar has nothing to disclose. Dr. Song has nothing to disclose. Dr. Ess has nothing to disclose. Dr. Jhu has nothing to disclose. Dr. Cutting has nothing to disclose.