Persistent isodense intraventricular hematoma caused by intraventricular saccular aneurysm

Area of Science:

• Neurology
• Radiology
• Neurosurgery

Background:

• Intraventricular hemorrhage (IVH) is a serious condition often diagnosed with neuroimaging.
• Intraventricular saccular aneurysms are rare causes of IVH, posing diagnostic difficulties.

Observation:

• A case of IVH secondary to an intraventricular saccular aneurysm was observed.
• Serial computed tomograms (CTs) showed the hematoma becoming progressively isodense, mimicking resolution.

Findings:

• The isodense appearance of the hematoma on serial CT scans created a false impression of resolution.
• Cerebral angiography was crucial for definitively diagnosing the intraventricular saccular aneurysm as the hemorrhage source.

Implications:

• This case underscores the potential for imaging artifacts in diagnosing IVH.
• Highlights the importance of considering rare etiologies like saccular aneurysms in IVH.
• Emphasizes the complementary role of angiography in confirming diagnoses suggested by CT.