Prognostic Value of the IntracerebralHematoma Volume-to-Cerebrospinal Fluid Volume Ratio in Patients with Spontaneous Basal Ganglia Hemorrhage Undergoing Non-Surgical Treatment

Objective 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. Methods 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. Results 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, with IHV/CSFV showing the strongest predictive capability. 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%. Conclusion For patients with spontaneous basal ganglia hemorrhage undergoing non-surgical treatment, admission SBP and the ratio of IHV/CSFV were identified as independent predictors of poor prognosis. Among these, IHV/CSFV demonstrated the strongest association with outcomes, offering a reliable and non-invasive method for prognosis prediction. Additionally, CSFV was significantly correlated with MTDTV, suggesting that CSFV could be effectively estimated through MTDTV measurements, further aiding clinical decision-making.