Prognostic value of the intracerebral hematoma volume-to-cerebrospinal fluid volume ratio in patients with spontaneous basal ganglia hemorrhage undergoing non-surgical treatment.

Authors

Zhangwei Yan, Xu Xu, Tao Sun, Xingwang Zhou, Han Peng, Xiaoyu Wang, Junshuan Cui, Hua Yang, Xin Xiang

Published in

BMC neurology. Jul 20, 2026. Epub Jul 20, 2026.

Abstract

This study aims to evaluate the prognostic value of the ratio of intracerebral hematoma volume (IHV) to cerebrospinal fluid volume (CSFV) in patients with basal ganglia hemorrhage undergoing non-surgical treatment. By providing a quantitative reference for clinical decision-making, this research seeks to facilitate the early identification of patients with poor prognoses and to support the selection of optimal treatment strategies tailored to individual needs.
This retrospective study included patients with spontaneous basal ganglia hemorrhage who received non-surgical treatment at our hospital between January 2017 and October 2020. IHV, CSFV, and the maximum transverse diameter of the third ventricle (MTDTV) were measured, and baseline characteristics were collected. Prognosis was assessed at three months using the modified Rankin Scale (mRS), with scores ≤2 indicating good outcomes and scores ≥3 indicating poor outcomes. Correlations between clinical variables and prognosis were analyzed.
A total of 125 patients were included in this study, among whom 74 (59.2%) experienced poor outcomes. Univariate analysis revealed significant differences in NIHSS score, GCS score, IHV, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at admission, CSFV, IHV/CSFV, and MTDTV (P<0.05). Logistic regression analysis identified IHV/CSFV (OR=1.074, P=0.041) and SBP at admission (OR=1.052, P=0.005) as independent predictors of patient outcomes.IHV/CSFV demonstrated good discriminatory performance and may reflect the balance between hematoma burden and intracranial CSF reserve, potentially complementing established predictors. The area under the ROC curve for IHV/CSFV was 0.810 (95% CI: 0.733-0.887), with a cutoff value of 18.35% for predicting poor outcomes, yielding a sensitivity of 67.57% and specificity of 92.16%.
For patients with spontaneous basal ganglia hemorrhage undergoing non-surgical treatment, admission SBP and the IHV/CSFV ratio were independently associated with poor prognosis in this cohort. As an exploratory composite imaging marker, IHV/CSFV was associated with outcome in our cohort and may represent a non-invasive, exploratory candidate marker for risk stratification that warrants further validation. Additionally, CSFV was significantly correlated with MTDTV, suggesting that CSFV could be effectively estimated through MTDTV measurements, a finding that could aid clinical decision-making.

PMID:
42477624
Bibliographic data and abstract were imported from PubMed on 21 Jul 2026.

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