Comparison of Acute Moyamoya Disease-Related and Idiopathic Primary Intraventricular Hemorrhage in Adult Patients.

Abstract

OBJECTIVE\nPrimary intraventricular hemorrhage (PIVH) is a rare condition in adult patients. PIVH occurs frequently in adult hemorrhagic Moyamoya disease (MMD). Idiopathic PIVH is defined as PIVH without cerebrovascular abnormalities. This study is aimed to compare the baseline characteristics and outcomes of acute MMD-related and idiopathic PIVH.\n\n\nMETHODS\nAdult patients with acute MMD-related or idiopathic PIVH were retrospectively included. Baseline characteristics and outcomes at discharge were obtained and compared. Chi-square test, Student s t-test, or rank-sum test were used in statistical analyses.\n\n\nRESULTS\nThis study finally included 32 patients with acute MMD-related PIVH and 112 with acute idiopathic PIVH. Patients with acute MMD-related PIVH were significantly younger (53.3 ± 15.8 vs. 42.8 ± 12.2 years, P < 0.001). The admission systolic blood pressure in patients with acute idiopathic PIVH was significantly higher (161.7 ± 30.9 vs. 134.6 ± 24.6 mm Hg, P < 0.001). Patients with acute idiopathic PIVH had significantly higher admission serum urea (5.68 ± 2.66 vs. 4.34 ± 1.62 mmol/L, P\xa0= 0.008), cystatin C (0.97 ± 0.72 vs. 0.68 ± 0.16 mg/L, P\xa0= 0.023), and uric acid (309.01 ± 105.97 vs. 242.24 ± 77.65 μmol/L, P\xa0= 0.001). In patients with acute MMD-related PIVH, only one (3.1%) patient was dead at discharge. In contrast, a total of 22 (19.6%) patients with acute idiopathic patients died at discharge (P\xa0= 0.027).\n\n\nCONCLUSIONS\nCompared with patients with acute idiopathic PIVH, patients with acute MMD-related PIVH have younger age, lower blood pressure, and better renal function. Moreover, patients with acute MMD-related PIVH have lower short-term mortality.