BACKGROUND/AIMS: The presence and growth of intraventricular haemorrhage (IVH) are well-established predictors of poor functional outcome in patients with intracerebral haemorrhage (ICH). The impact of haemorrhage location has not been well-explored. We aimed to investigate features of IVH which were most strongly associated with clinical outcomes.
METHODS: We performed pooled analysis of the STOP-AUST/STOP-MSU trials. IVH volume, location and Graeb score were assessed by two authors. Associations with outcomes were assessed using logistic regression, adjusted for baseline hematoma volume.
RESULTS: Among the 294 participants (median age 68years, 39.8% female, 50.7% tranexamic acid [TXA]), IVH was present in 70 (23.8%) on baseline imaging, and 114 (38.8%) on 24-hour imaging. For patients with IVH, baseline median IVH volume was 5.59ml (IQR 2.45-11.16ml), and 24-hour IVH volume was 4.31ml (IQR 1.58-11.69ml).
New IVH was most strongly associated with poor functional outcome (mRS4-6; aOR 9.55 [95%CI 3.88-23.54], p<0.01), followed by presence of any IVH on 24-hour imaging (aOR 5.28 [95%CI 2.99-9.32], p<0.01). There was no association with poor functional outcome for IVH location in the third or fourth ventricles, or Graeb score (baseline or 24-hour).
TXA did not attenuate IVH as there was no difference in rates of any IVH growth (p=0.550), IVH growth by ≥1ml (p=0.506) or development of new IVH (p=) in patients treated with TXA vs placebo.
CONCLUSIONS: IVH development and growth on 24-hour imaging was most strongly associated with poor outcomes. There was no observed association between location and outcome, but larger studies may be required to address this question.