Primary intraventricular hemorrhage in adults

Area of Science:

• Neurology
• Vascular Neurology

Background:

• Primary intraventricular hemorrhage (IVH) is a rare condition.
• Hypertension and cerebrovascular occlusive disease are potential contributing factors.

Observation:

• Five adult patients presented with IVH, headache, confusion, and minimal focal neurological deficits.
• All patients had a history of hypertension.
• Cerebral angiography revealed significant internal carotid artery occlusion or stenosis in four patients and middle cerebral artery occlusion in one.

Findings:

• Pathological examination of one patient revealed hemorrhagic lacunar infarcts adjacent to the lateral ventricle.
• Direct continuity was observed between a lacunar infarct and the intraventricular hematoma, suggesting a potential mechanism.

Implications:

• This suggests a possible mechanism for primary IVH in patients with hypertension and severe internal carotid artery disease.
• These findings highlight a specific risk profile for this unusual type of intracranial hemorrhage.