Association between eye position on brain scan and hospital mortality in acute intracerebral hemorrhage

• Published in: European journal of neurology Vol. 23; no. 4; pp. 831 - 835
• Main Authors: Frusch, K. J. M., Houben, R., Schreuder, F. H. B. M., Postma, A. A., Staals, J.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.04.2016; John Wiley & Sons, Inc
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - mortality; Confidence intervals; conjugated eye deviation; eye position; Female; Hemorrhage; Hospital Mortality; Humans; intracerebral hemorrhage; Male; Middle Aged; Mortality; Ocular Motility Disorders - diagnostic imaging; Ocular Motility Disorders - etiology; Prognosis; Regression analysis; Retrospective Studies; stroke; Young Adult; eye position; intracerebral hemorrhage; mortality; conjugated eye deviation; stroke
• ISSN: 1351-5101; 1468-1331
• DOI: 10.1111/ene.12951

Background and purpose Conjugate eye deviation (CED) and horizontal skew deviation are often seen in patients with intracerebral hemorrhage (ICH), but its prognostic significance is unclear. In this study, the association between brain scan assessed eye position and hospital mortality in patients with supratentorial ICH was tested. Methods A retrospective analysis was performed in 316 patients with supratentorial ICH. Eye position was measured on first brain computed tomography or magnetic resonance imaging. Patients with CED, horizontal skew deviation or no deviation were distinguished. The association between eye position and hospital mortality was assessed using logistic regression analysis. Results Conjugate eye deviation was present in 96 (30.4%), skew deviation in 44 (13.9%) and no deviation in 176 (55.7%) patients. In patients with CED, 81.3% had an eye position to the ipsilateral side of the hemorrhage. In univariable regression analysis, skew deviation was associated with mortality (odds ratio 3.10, 95% confidence interval 1.57–6.11; P = 0.001). In multivariable regression analysis, adjusting for age, ICH volume, intraventricular extension and Glasgow Coma Scale, eye position was not independently associated with mortality. Conclusion Horizontal skew eyes were found to be an unfavorable prognostic factor. However, this was not independent of other important predictors of ICH mortality and is most probably explained by its association with worse initial clinical presentation.