Predominant Intraventricular Hemorrhage From a Ruptured Posterior Communicating Artery Aneurysm

Abstract

CaseA 45-year-old woman presented with acute onset of headache and confusion. A computed tomography (CT) of the brain showed predominant intraventricular hemorrhage (IVH) without significant subarachnoid hemorrhage ( Figure 1A and B). A CT angiography showed a laterally oriented, left posterior communicating artery (PCOM) aneurysm ( Figure 1C). This aneurysm, confirmed by cerebral angiography ( Figure 1D), was successfully coil embolized. The ventriculostomy was placed in the right lateral ventricle to treat the obstructive hydrocephalus. The patient survived without major neurological deficits.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 Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. FundingThe authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dr Nakagawa was supported in part by the National Institute on Minority Health and Health Disparities of the National Institutes of Health (P20MD000173

Solitary intraventricular hemorrhage without subarachnoid hemorrhage due to aneurysmal rupture: a case report

“…In many previous cases, vascular abnormalities such as arteriovenous malformations (AVMs) and cerebral aneurysmal ruptures, could have been the cause of bleeding 4). To the best our knowledge, there are very rare cases of solitary IVH without SAH result from aneurysmal ruptures 16891112131926). We describe our experience with diagnosis and treating an extremely rare case of solitary IVH without SAH due to aneurysmal rupture.…”