Primary intraventricular hemorrhage: cause unknown

Case contributed by Subash Thapa
Diagnosis certain


Sudden onset of headache. No loss of consciousness and no focal neurological deficits. No history of trauma. Patient is hypertensive.

Patient Data

Age: 30 years
Gender: Male

There is a hyperdense area of blood density along the left anterior horn, left lateral ventricle and the third ventricle.

Bilateral posterior cerebral arteries originate from the prominent right and left posterior communicating artery respectively suggestive of bilateral fetal origin of PCA.

No aneurysm noted.

Case Discussion

The patient has no history of trauma and cerebral angiography showed no aneurysm. Primary intraventricular hemorrhage (IVH) is less common than the secondary IVH.

Cerebral angiography showed bilateral fetal origin of the PCAs, which is seen in ~8% population as a common anatomical variant. 

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