Unusual presentation of more common disease/injury
Intraventricular haemorrhage without subarachnoid haemorrhage due to a ruptured aneurysm
1 James Cook University Hospital, Neurosurgery, Marton Road, Middlesbrough TS4 3BW, UK
2 Skendleby Drive, Newcastle NE3 3GJ, UK
3 James Cook University Hospital, Neuroradiology, Marton Road, Middlesbrough TS4 3BW, UK
Correspondence to:
K S Manjunath Prasad, manjunath.prasad{at}doctors.org.uk
The incidence of aneurysmal subarachnoid haemorrhage (SAH) in the UK is about 10 per 100 000 of the population per year and it is a potentially fatal condition. Prompt recognition and referral to a neurosurgical unit is crucial for a better outcome. A typical history of sudden severe headache, CT scan and sometimes a lumbar puncture would help clinch the diagnosis. Though intracerebral haemorrhage (ICH) and intraventricular haemorrhage (IVH) are not uncommon after an aneurysmal rupture, ICH and/or IVH without SAH are rare (<2%). In such cases, a high index of suspicion is needed to deliver the correct management. This report describes a case of posterior communicating artery aneurysm presenting with pure IVH on CT. The aneurysm was diagnosed by performing a CT angiogram and the patient underwent a successful coil embolisation.
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