Dural arteriovenous fistula causing primary intraventricular haemorrhage

Primary intraventricular haemorrhage is a rare presentation of a dural arteriovenous fistula. We describe the case of a 52-year-old woman with a past history of idiopathic intracranial hypertension who presented with sudden-onset severe headache The CT scan on admission showed primary intraventricular haemorrhage with no associated haemorrhage in the brain parenchyma or the extra-axial compartment The cerebral angiogram demonstrated a dural arteriovenous fistula involving the left sigmoid and transverse sinuses which was successfully embolised transvenously. Subependymal venous congestion and rupture secondary to retrograde venous drainage has been proposed as the cause for this presentation.