Post-Traumatic IVH and Left Thalamic Edema After Non-Penetrating Head Injury in a 25-Year-Old Male Patient Treated With Nonsurgical Management: Illustrative Case
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Published on: February 10, 2020
Ermias Fikru Yesuf1, Mestet Yibeltal Shiferaw1, Tsegazeab Laeke T/Mariam1
1Neurosurgery Division, Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia.
Abstract:
Intraventricular hemorrhage (IVH) can occur because of different causes, one of which is a non-penetrating head injury. Traumatic IVH is rare and usually associated with a poor prognosis, mainly due to other related injuries. It can be the only computed tomography finding, but it is often associated with other intracranial bleeding events. Traumatic IVH is presumed to result from periventricular parenchymal bleeding or rupture of subependymal veins. Studies correlating thalamic edema with traumatic IVH are scarce. A 25-year-old male patient experienced loss of consciousness, subarachnoid hemorrhage, IVH involving the lateral and third ventricles, and left thalamic edema after a road traffic accident. The patient initially received conservative treatment in the intensive care unit, showed improvement, was transferred to the ward, and was discharged without complications. IVH takes a long time to resolve because of poor dissolution of blood clots and hemolysis in the cerebrospinal fluid. Expansile edema in the left thalamic region with progressive improvement suggests venous insufficiency, although venography does not confirm it. The relationship between thalamic edema and IVH remains unclear and requires further investigation. Conservative management and monitoring of complications are crucial.
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