Intraventricular haemorrhage without subarachnoid haemorrhage due to a ruptured aneurysm

Abstract

The incidence of aneurysmal subarachnoid haemorrhage (SAH) in the UK is about 10 per 100 000 of the population per year and it is a potentially fatal condition. Prompt recognition and referral to a neurosurgical unit is crucial for a better outcome. A typical history of sudden severe headache, CT scan and sometimes a lumbar puncture would help clinch the diagnosis. Though intracerebral haemorrhage (ICH) and intraventricular haemorrhage (IVH) are not uncommon after an aneurysmal rupture, ICH and/or IVH without SAH are rare (<2%). In such cases, a high index of suspicion is needed to deliver the correct management. This report describes a case of posterior communicating artery aneurysm presenting with pure IVH on CT. The aneurysm was diagnosed by performing a CT angiogram and the patient underwent a successful coil embolisation.

Predominant Intraventricular Hemorrhage From a Ruptured Posterior Communicating Artery Aneurysm

“…Although ruptured cerebral aneurysms rarely present as isolated IVH, laterally oriented PCOM aneurysms can rupture through the medial temporal lobe, causing predominant IVH without subarachnoid hemorrhage. 1 This case highlights the importance of urgent vascular imaging for optimal IVH evaluation and management. 2…”

Anterior Communicating Artery Aneurysm Uncommon Hemorrhagic Presentation: Case Report

“…Although many cases of isolated subdural hematoma or ICH associated to aneurysmal bleeding have been reported, 10,11 only few cases of pure IVH have been cited. 7,12,13 The two most common causes of isolated IVH are aneurysm rupture and arteriovenous malformation, while moyamoya disease and dural arteriovenous fistula are rarer. 8 The features and location of the anuerysm can predispose to direct hemorrhage into the parenchyma or ventricular system.…”