Primary Intraventricular Hemorrhage due to Rupture of Angiographically Occult Vascular Malformation: Report of a Case

Yu-Kai Cheng, Ming-Shian Lu, Jen-Tsung Yang, Ming-Hsueh Lee, Chen-Hsing Su, Ting-Chung Wang

43卷1期 (2010/2)

43-46

Primary intraventricular hemorrhage (PIVH) is a rare neurological disease. Most
articles in the literature recommend angiography as a standard examination to
exclude potential vascular lesions. We present a 48-year-old male with PIVH
disclosed by non-contrast brain computerized tomography (CT). CT angiography
was performed because of the patient’s comatous status and high suspicion of a
vascular lesion. Contrast extravasation into the ventricles associated with severe
hydrocephalus was noted. Cerebral angiography was performed soon after surgery
for the cause of acute hydrocephalus. However, no vascular lesion was detected. One
week later, a magnetic resonance imaging of the brain demonstrated one
hyperintense lesion in the left lateral ventricle near the foramen of Monro. A
vascular lesion was documented by histopathological examination. Two weeks after
surgery, the patient was discharged. About 10% of cerebrovascular malformations
are angiographically occult. A normal angiographic examination does not
necessarily indicate the absence of a vascular lesion. We suggest performing brain
MRI for PIVH patients if the cerebral angiography appears “normal”.

angiographically occult vascular malformation, cerebral angiography,intraventricular hemorrhage, magnetic resonance imaging

Case Report