BMJ Case Reports 2009; doi:10.1136/bcr.11.2008.1184
  • Unusual presentation of more common disease/injury

Intraventricular haemorrhage without subarachnoid haemorrhage due to a ruptured aneurysm

  1. K S Manjunath Prasad1,
  2. Shuaibu Sule Dambatta1,2,
  3. James E Dervin3
  1. 1
    James Cook University Hospital, Neurosurgery, Marton Road, Middlesbrough TS4 3BW, UK
  2. 2
    Skendleby Drive, Newcastle NE3 3GJ, UK
  3. 3
    James Cook University Hospital, Neuroradiology, Marton Road, Middlesbrough TS4 3BW, UK
  1. K S Manjunath Prasad, manjunath.prasad{at}
  • Published 7 April 2009


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.


  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication.

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