4. INTRODUCTION
IVH usually secondary to intraparenchymal
haemorrhage
Isolated IVH is rare (< 4%)
First defined by Sanders as bleeding in the
ventricular system without a discernable
parenchymal component or arising within 15 mm
from the ventricular wall
Flint AC, Roebken A, Singh V. Primary intraventricular hemorrhage: yield of diagnostic angiography and clinical outcome. Neurocrit Care 2008; 8 : 330–6.
Srivastava T, Sannegowda RB, Satija V, Jain RS, Tejwani S, Mathur T. Primary intraventricular hemorrhage: clinical features, risk factors, etiology, and yield of diagnostic
cerebral angiography. Neurology India. 2014 Mar 1;62(2):144.
5. CAUSES & PREDISPOSING FACTORS
Barnaure I, Liberato AC, Gonzalez RG, Romero JM. Isolated intraventricular haemorrhage in adults. The British journal of radiology. 2016 Dec 20;90(1069):20160779.
6. CAUSES & PREDISPOSING FACTORS
Srivastava T, Sannegowda RB, Satija V, Jain RS, Tejwani S, Mathur T. Primary intraventricular hemorrhage: clinical features, risk factors, etiology, and yield of diagnostic
cerebral angiography. Neurology India. 2014 Mar 1;62(2):144.
7. CAUSES & PREDISPOSING FACTORS
Most cases due to vascular malformations.
25-45 % unknown etology. Probably due small to
vascular malformations, invisible with angiography.
Work up with MRI / high resolution CT
Marti-Fabregas J, Piles S, Guardia E, MartiVilalta JL. Spontaneous primary intraventricular hemorrhage: clinical data, etiology and outcome. J Neurol 1999; 246 : 287–91.
Passero S, Ulivelli M, Reale F. Primary intraventricular haemorrhage in adults. Acta Neurol Scand 2002; 105 :115–19.
Giray S, Sen O, Sarica FB, Tufan K, Karatas M, Goksel BK, et al. Spontaneous primary intraventricular hemorrhage in adults: clinical data, etiology and outcome. Turk
Neurosurg 2009;19: 338–44.
8. DIAGNOSIS
Clinical and physical examination
CT/CT angiography
MRI/MR angiography
Catheter angiography
Barnaure I, Liberato AC, Gonzalez RG, Romero JM. Isolated intraventricular haemorrhage in adults. The British journal of radiology. 2016 Dec 20;90(1069):20160779.
9. DIFFERENTIAL DIAGNOSIS
Intraventricular pus
Colloid cysts
Hyperdense tumoral lesions (e.g. Lymphoma)
Barnaure I, Liberato AC, Gonzalez RG, Romero JM. Isolated intraventricular haemorrhage in adults. The British journal of radiology. 2016 Dec 20;90(1069):20160779.
10. TREATMENT
Treat underlying etiologies
Conservative management
Hydrocephalus in around 40 % patients shunting
Srivastava T, Sannegowda RB, Satija V, Jain RS, Tejwani S, Mathur T. Primary intraventricular hemorrhage: clinical features, risk factors, etiology, and yield of diagnostic
cerebral angiography. Neurology India. 2014 Mar 1;62(2):144.