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Updated: Jan 20, 2026
Modeling Neonatal Intraventricular Hemorrhage Through Intraventricular Injection of Hemoglobin
Primary Intraventricular Hemorrhage in Pediatric Patients: Causes, Characteristics, and Outcomes
Rui Guo1, Ruiqi Chen1, Zhiyuan Yu1
1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Insights
Primary intraventricular hemorrhage (PIVH) in children is rare, with arteriovenous malformations being the most common cause. Higher Graeb scores predict poor outcomes, highlighting the need for targeted surgical treatment.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Vascular Malformations
Background:
- Primary intraventricular hemorrhage (PIVH) is a rare condition in children with poorly understood causes and outcomes.
- Limited data exists on the specific characteristics and prognostic factors of PIVH in pediatric populations.
Purpose of the Study:
- To investigate the causes, clinical characteristics, and outcomes of primary intraventricular hemorrhage in pediatric patients.
- To identify factors associated with unfavorable outcomes in children with PIVH.
Main Methods:
- Retrospective analysis of 18 pediatric patients (1 month to 21 years) with PIVH over a 7-year period.
- PIVH defined as hemorrhage confined to the ventricular system.
- Clinical data, etiologies, treatments, and outcomes (including Graeb score) were reviewed.
Main Results:
- Arteriovenous malformations (66.7%) were the leading cause of PIVH, followed by moyamoya disease and aneurysms.
- Headache and vomiting were the most frequent presenting symptoms.
- A higher Graeb score correlated with unfavorable short-term and long-term outcomes.
Conclusions:
- Arteriovenous malformations are the predominant etiology for PIVH in children.
- Surgical intervention targeting the underlying cause is crucial for clinical improvement.
- Elevated Graeb scores at admission are indicative of poor prognosis in pediatric PIVH cases.
Background:
Primary intraventricular hemorrhage (PIVH) is rare, and causes, characteristics, and outcomes remain unknown in children.
Methods:
We retrospectively analyzed the clinical characteristics of patients 1 month to 21 years of age who were admitted to the hospital with PIVH over a 7-year period. PIVH was defined as bleeding confined to the ventricular system without parenchymal or subarachnoid hemorrhage involvement.
Results:
Of 18 included patients, 55.6% were female, and mean age was 13.8 ± 6.0 years. The most common presenting symptoms were headache (77.8%) and vomiting (33.3%). In 15 patients (83.3%), known etiologies were diagnosed, including arteriovenous malformations (66.7%), moyamoya disease (11.1%), and aneurysms (5.6%). Idiopathic PIVH was the diagnosis in 3 patients (16.7%). Surgery was performed in 15 patients (83.3%), and 3 patients (16.7%) received conservative treatment. Four patients (28.6%) had an unfavorable outcome at discharge, and 3 patients (16.7%) had an unfavorable outcome at the 3-month follow-up. Higher Graeb score was associated with an unfavorable outcome in both short-term and long-term follow-up.
Conclusions:
Arteriovenous malformations were diagnosed in most pediatric patients with PIVH. Specific surgical treatment of underlying etiologies should be required to increase clinical improvement. Children with a higher Graeb score at admission tended to have poor early and late outcomes.
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