Management of Intraventricular Haemorrhage in Patients with Haemorrhagic Cerebrovascular Diseases

Abstract

The authors propose a four-grade classification for intraventricular haemorrhage (IVH) caused by haemorrhagic cerebrovascular diseases. Grading is based on the distribution and volume of the haematoma in the ventricular system as revealed by computed tomography (CT). In Grade I IVH, CT shows no haematoma in the ventricular system, but the cerebrospinal fluid contains some fresh blood; Grade II IVH fills a circumscribed portion of one or both lateral ventricles. This grade is divided into two: Grade II, having a haematoma volume of, or less than 20 ml in the ventricular system and Grade 11, of more than 21 ml; Grade III IVH fills the entire length of one lateral ventricle and none, or circumscribed portion, of the other lateral ventricle; and Grade IV IVH entirely fills both lateral ventricles. This grading scale correlated with the mortality and morbidity of the IVH patients. Its application will assist in the selection of continuous ventricular drainage or direct evacuation of intraventricular haematoma as the management method.

Key Words:

• Intraventricular haemorrhage
• cerebrovascular disease
• grading system
• continuous ventricular drainage
• direct haematoma evacuation