Intraventricular Hemorrhage (Graeb) Score Predicts Prognosis in Lobar and Thalamic Intracerebral Hemorrhage (P2.256)

Objective: We aimed to evaluate the IVH score as a predictor of short term functional outcome in lobar and thalamic ICH patients. Background: Although the Intracerebral Hemorrhage score (ICHS) takes into account the presence of Intraventricular Hemorrhage (IVH) it does not evaluate the severity of IVH. Prior reports suggest that ICH location impacts IVH. Design/Methods: We performed a retrospective review of lobar (n=49) and thalamic (n=27) ICH patients who presented to our center from September 2014 through November 2015, excluding cases with underlying structural malformation. Our exposure of interest was the IVH score, calculated using the original Graeb method. Our outcome of interest was poor short term functional outcome, as measured by the modified Rankin Scale (mRS) 4–6. IVH scores by ICH location (lobar vs. thalamus) were also evaluated. Results: Thalamic ICH patients had a higher median IVH score than lobar ICH patients 4 [IQR 2, 8] vs. 1 [IQR 0, 4], p=0.030). For each 1 point increase in IVH score, lobar and thalamic ICH patients had twice the odds of discharge mRS 4–6 (OR 1.94, 95% CI 1.18–3.17, p=0.008). This association remained after adjustment for ICH location (OR 2.00, 95% CI 1.17–3.45, p=0.012). Conclusions: An increase in IVH score is associated with higher odds of poor functional outcome at discharge in both lobar and thalamic ICH patients. In our sample, this proved to be true for all categories of IVH score, including patients with hemorrhage in regions that do not tend to be associated with intraventricular extension. Disclosure: Dr. Pennington has nothing to disclose. Dr. Albright has nothing to disclose. Dr. Lyerly has nothing to disclose. Dr. Singh has nothing to disclose. Dr. Gropen has nothing to disclose. Dr. Shapshak has nothing to disclose.