Etiological factors of spontaneous primary intraventricular hemorrhage

Objectives: Spontaneous primary intraventricular hemorrhage (SPIVH) is a distinct subtype of nontraumatic intracerebral hemorrhage in the ventricular system without a recognizable parenchymal component. The purpose of this study was to analyze the etiological characteristics of SPIVH.Patients and Methods: We analyzed the records of 88 patients with SPIVH that had been evaluated and treated at our institute from January 2011 to May 2018. All the patients with IVH associated with trauma were excluded. All the patients underwent at least 1 vascular imaging examination.Results: There were 52 (59.1%) males and 36 females, aged between 5 and 76, with an average age of 38.1 years. Fourteen (15.9%) patients were in pediatric age range. Out of the 88 patients, vascular lesions were found in 46 patients (52.3%), hypertension in 21 (23.9%), coagulopathy in 1 (1.1%), tumor in 1 (1.1%), and idiopathic causes in 19 (21.6%). Among patients with vascular lesions, AVMs (43.5%) were the most dominant form (20/46), followed by MMD (28.2%), aneurysms (23.9%), AVMs with aneurysm (2.2%) and dAVF (2.2%).Conclusions: Spontaneous primary intraventricular hemorrhage is rare in clinical practice, hypertension and arteriovenous malformation are the most common factor. The main etiological factors of hemorrhage are various in different age groups.