BMJ Case Reports 2009; doi:10.1136/bcr.12.2008.1410
  • Reminder of important clinical lesson

Acute vomiting and mental status changes: a case of acute intraventricular haemorrhage from an optic chiasm tumour

  1. Jonathan N Johnson1,
  2. Ravneet K Dhillon2,
  3. Jana L Anderson3
  1. 1
    Mayo Clinic, Pediatrics, 200 First Street SW, Rochester, MN 55905, USA
  2. 2
    Mayo Clinic, Emergency Medicine, 200 First Street SW, Rochester, MN 55905, USA
  3. 3
    Mayo Clinic, Pediatrics and Emergency Medicine, 200 First Street SW, Rochester, MN 55905, USA
  1. Jana L Anderson, anderson.jana{at}
  • Published 1 June 2009


In this article, we describe a 5- year-old girl who presented to an emergency department with 1 day of vomiting, mental status changes and decreased activity. Imaging studies revealed a mass in the optic chiasm which had haemorrhaged into her ventricles causing acute hydrocephalus. This case highlights the diligence and broad differential one must have when evaluating a child presenting with a sole complaint of vomiting.


  • Competing interests: none.

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

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article