Intraventricular hemorrhage

In subarachnoid hemorrhage due to a ruptured intracranial aneurysm or arteriovenous malformation, surgical intervention to clip or ablate the vascular abnormality substantially reduces mortality from rebleeding. The benefits of surgery are less well documented in cases of primary intracerebral hemorrhage. In patients with intracerebral hematomas, insertion of an intraventricular drain with monitoring of intracranial pressure is... 

A Cochrane metaanalysis shows the benefit of antenatal corticosteroids for fetal lung maturation to prevent respiratory distress syndrome, intraventricular hemorrhage, and death in infants delivered prematurely. 

J. H. Meek, L. Tyszczuk, C. E. Elwell, and J. S. Wyatt. Low cerebral blood flow is a risk factor for sever intraventricular hemorrhage. Archives of Disease in Childhood, 81 F15-F18, 1999. 

Chiidren Safety and efficacy have not been determined in newborns germinal matrix intraventricular hemorrhage occurs more often in low-birth-weight infants receiving heparin. 

OR = 2.9 Cl = 1.3, 6.9), chorioamnionitis (OR = 10 Cl = 2.1, 65), and endometritis (OR = 3.6 Cl = 1.7, 8.1). Respiratory distress and intraventricular hemorrhage were similar in the two groups. Although the study was non-randomized the results suggest an increased risk of neonatal infection and death after multiple courses of dexamethasone during pregnancy. 

Primary intraventricular hemorrhage is very unusual, except in premature babies. In adults, a cause is not always found. Some may be secondary to a vascular malformation in the ventricular wall (Gates et al. 1986 Darby et al. 1988). The clinical features may be indistinguishable from subarachnoid hemorrhage and it may only be differentiated at autopsy. 

Insertion of a ventricular catheter can be life saving in patients with cerebellar hemorrhage and hydrocephalus. In patients with supratentorial hemorrhage and hydrocephalus, however, the benefits of cerebrospinal fluid (CSF) diversion are less certain. In patients with extensive intraventricular hemorrhage secondary to deep intraparenchymal or aneurysmal rupture, drainage of CSF is performed in some centers. Systematic reviews of observational studies suggest that this procedure may be helpful, especially when it is combined with instillation of fibrinolytic drugs. However, randomized trials are needed (Lee et al. 2003 Fountas et al. 2005). 

Fountas KN, Kapsalaki EZ, Parish DC et al. (2005). Intraventricular administration of rt-PA in patients with intraventricular hemorrhage. South Medical Journal 98 767-773... 

Subarachnoid hemorrhage Acute painful neck conditions Meningitis/encephalitis Cerebellar/brainstem stroke Intraventricular hemorrhage Recent head injury Migraine... 

ECG abnormalities in children who ingested castor beans have been noted by Kaszas and Papp (1960). These include QT interval lengthening, repolarization changes, and intraventricular conduction disturbances. Crompton (1980) later reported on experiments on pigs that experienced hemorrhagic lesions and an abnormal ECG due to ricin. At the present time, no antidotes or effective therapy are available to counteract the effects of ricin. 

Initially, it was believed that benzyl alcohol was only toxic in neonates who received doses greater than 99mg/kg,f" but it has been suggested that lower doses may be toxic, resulting in kernicterus and intraventricular hemorrhages.Therefore, pharmaceutical preparations and fluids containing benzyl alcohol should be avoided in premature neonates. 

Hiller, J.L. Benda, G.I. Rahatzad, M. Alen, J.R. Culver, D.H. Carlson, C.V. Reynolds, J.W. Benzyl alcohol toxicity Impact on mortality and intraventricular hemorrhage among very low birth weight infants. Pediatrics 1986, 77, 500-506. 

Jadine, D.S. Rogers, K. Relationship of benzyl alcohol to kernicterus, intraventricular hemorrhage, and mortality in preterm infants. Pediatrics 1989, 83, 153-160. 

Schwarz S, Schwab S, Steiner HH, Hacke W. Secondary hemorrhage after intraventricular fibrinolysis a cautionary note a report of two cases. Neurosurgery 1998 42(3) 659-63. 

Indometacin is also used in preterm infants as prophylaxis against intraventricular hemorrhage. In a prospective, randomised, placebo-controlled trial in 431 preterm neonates, low-dose indometacin prevented intraventricular hemorrhage without adverse cognitive or motor outcomes at 36 months (13). 

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