intraventricular hemorrhage

Emergency RN · Apr 8, 2010

We had a fairly young patient admitted the other day with a massive intraventricular hemorrhage and the doctor and family chose not to do anything and let her pass away. I was wondering if anyone has had this same experience and why would they not try and do something about it. She did have a fairly extensive medical history.

While I have not had the experience of such a patient, from what I can gather from a review of the literature, Intraventricular Hemorrhage (IVH) in an adult is generally a very bad diagnosis with extremely poor outcomes. They're usually the result of forceful head trauma or extensive subarachnoid bleeding. If the hemorrhage is secondary to hypertension, the prognosis is often regarded to be so dismal that intervention then becomes moot.

It sounds like that may have been the clinical picture apparent in your discussed case.

ello7 · Apr 8, 2010

A massive IVH could cause the brain to shift, causing debilitating injuries or brain death with a very very very slim chance of ANY recovery. Family probably didn't want her to suffer, especially with her PMH.

Lacie, BSN, RN · Apr 9, 2010

My husband passed away at age 34 with same diagnosis which occurred in his sleep. His only complaint was a mild headache when he went to bed. He was newly diagnosed with mild hypertension a month before and of course like many men hate going to docs so put off his f/u visit. In our case we knew, just knew it was the right decision. In order to prep for organ donation brain death had to be confirmed which only reiterated our suspicions that he would have no recovery or an extremely poor quality of life if he did survive such an insult. It's a hard decision for families and sometimes they realize the end result would be either futile or the quality of life if survival would be very minimal. We had discussed these issues previously so we knew what he would have wanted under such circumstances. Could also be the case in this situation.