Primary intraventricular hemorrhage in adult--an analysis of 24 cases

Primary intraventricular hemorrhage in adults is rare, comprising only about 3.1 % of all intracranial hemorrhage. One of the major management tasks is to find out whether the hemorrhage is secondary to underlying structural vascular abnormality, such as arteriovenous malformation (AVM) and aneurysm, so that appropriate treatment can be carried out to prevent rebleeding. We retrospectively analyzed 24 patients with computerized tomography findings of intraventricular hemorrhage in our hospital from 1991 to 1996. Cerebral angiography was performed in eighteen patients. Eight patients (57%) had positive angiographic findings (five were AVM and three were aneurysm). The angiographic yield was five of seven patients (72%) younger than 45 years of age and three of eleven (27%) older than 45 years of age. On the basis of our results, we suggest that cerebral angiography should be considered for all primary intraventricular hemorrhage patients who are younger than 45 years old.