Hypertensive caudate hemorrhage prognostic predictor, outcome, and role ofexternal ventricular drainage

Background and Purpose-The purpose of the present study was to analyze the outcome and outcome predictors of caudate hemorrhage and role of external v entricular drainage in acute hydrocephalus. Methods-Clinical data from 36 consecutive patients with hypertensive caudat e hemorrhage was used in the present study. Age, gender, volume of parenchy mal hematoma, hematoma in the internal capsule, initial Glasgow Coma Scale (GCS), hydrocephalus, severity of intraventricular hemorrhage, and hemorrha gic dilatation of the fourth ventricle were analyzed for effect on outcome. Effect of external ventricle drainage for hydrocephalus was evaluated by c omparing preoperative and postoperative GCS scores. Results-By univariate analyses, poor outcome was associated with a poor ini tial GCS score (P=0.016), hydrocephalus (P <0.001), intraventricular hemorr hage severity (P <0.01), and hemorrhagic dilatation of the fourth ventricle (P=0.02). By multivariate analysis, stepwise logistic regression revealed that hydrocephalus was the only independent prognostic factor for poor outc ome (P <0.001). Postoperative 48-hour GCS score was better than the preoper ative score by use of pail-ed-sample t test (P <0.001). Conclusions-Hydrocephalus is the most important predictor of poor outcome. External ventricular drainage response for hydrocephalus was good in the pr esent study, whereas an early decision should be made regarding preoperativ e neurological condition.