The Morphological Classification And Clinical Significance Of The Rupture Of Thalamic Hemorrhage Into The Ventricle

Objective: To investigate the clinical significance of the original morphological classification of thalamic hemorrhage into the ventricle.Methods: retrospective analysis of the fourth hospital affiliated to China medical university,tiefa coal group hospital and yan ’an central hospital,A total of 296 patients with thalamic hemorrhage broken into ventricles of CT data,the import of hematoma in 3dslicer software reconstruction,according to the location of the hematoma broken into the ventricle can be divided into: the medial type(M),the former type(A),after type(P)and the type(S).The differences of patients’ natural information,cerebral parenchymal blood loss,ventricular blood loss,treatment plan and short-term prognosis were analyzed and compared among different subtypes.Results: 89 cases(30.1%)were M type,14 cases(4.7%)were A type,60 cases(20.3%)were P type,133 cases(44.9%)were S type.There was no significant difference in patients’ natural information among the four subtypes: gender(P =0.301 value),age(P=0.161 value),and bleeding side(P =0.865 value).Lateral ventricle blood loss was 9563±1155mm3 for type M,10229±4127mm3 for type A,17494±1942mm3 for type P,and 11275±1099mm3 for type S,and P was higher than that for type A(P=0.015),S(P=0.003)and M(P=0.0003).The blood loss of the third ventricle was 3686±290.1mm3 for type M,841.9 ±283.1mm3 for type A,971± 145.2mm3 for type P,and 813.6±104.7mm3 for type S,among which the M type was more than the other three types(P<0.0001).The blood loss of the fourth ventricle was 3165±362mm3 for type M,992.2±278.9mm3 for type A,837.2±202.8mm3 for type P,666.5±125.8mm3 for type S,and higher than that of the other three types(P<0.0001).The 3-month mortality of the four types was 49.44% for M type,7.14% for A type,26.67% for P type,and 23.32% for S type,among which M type was the highest(P =0.000792).Among the four types,70cases(78.7%)underwent surgery for type M,8 cases(57.1%)for type A,40 cases(66.7%)for type P,and 97 cases(72.9%)for type S.According to univariate analysis,the classification,conservative treatment and surgical treatment of thalamic hemorrhage into the ventricle are important factors affecting the prognosis of patients.Conclusion: 3D Slicer is of clinical significance in MAPS classification of cerebral ventricular hemorrhage.S type is the most common and A type is the least common.There was a significant correlation between M type and hematoma volume of the third and fourth ventricles,which was significant for assessing the risk of obstructive hydrocephalus.P type rupture into the lateral ventricle with the largest amount of bleeding,should be alert to hydrocephalus.Of the four types,type M is more likely to be treated surgically.The short-term prognosis of type 4 is the worst for type M and the best for type A.The morphology of the rupture of thalamic hemorrhage into the ventricle is closely related to the prognosis of the patients.