Efficacy of External Ventricular Drain in Cases of Hypertensive Intraventricular Bleed with Acute Hydrocephalus

Abstract

Hypertensive intracerebral hemorrhages (HICH) is characterized by direct bleeding into the cerebral parenchymal system. The most common localization for spontaneous intracerebral hemorrhages was Thalamus (27%), followed by Putamen and lobar regions. Intraventricular (IVH) bleed was present in 358 patients (14.2%). 315 patients (12.5%) had acute hydrocephalus after bleed and were included in our study. Between Feb 1990-Jan 2014, 2509 patients with hypertensive ICH were evaluated by the department of neurosurgery. The diagnosis was established easily and rapidly with computed tomography. Of these total cases, 358 patients had bleed in the ventricular system. 315 patients were selected for external ventricular drain (EVD) procedure on the basis of inclusion and exclusion criteria. At 1 year interval, 231 patients survived (73.3%). 112 (35%) patients had good outcome and were independent (Modified Rankin Scale 0-2). The rest needed varying degrees of assistance and care. The prognosis and results of treatment with external ventricular drainage (EVD) were recorded based on prognostic factors and Modified Rankin scale outcome. All study patients underwent surgery with EVD within 4 hrs of their hospital admission. Applying EVD had positive results and reversed the, early and late complications of acute hydrocephalus caused by IVH.