Shi Xiao-Yong, Lou Yue
Brain Center, Zhejiang Hospital, Hangzhou, Zhejiang Province, People's Republic of China.
Int Med Case Rep J. 2025 May 17;18:573-576. doi: 10.2147/IMCRJ.S521860. eCollection 2025.
Spontaneous primary intraventricular hemorrhage (IVH) is a rare type of intracranial hemorrhage that can be concentrated in one or more ventricles. The clinical symptoms after bleeding are diverse, if there is significant bleeding or hydrocephalus, external ventricular drainage (EVD) treatment is often required. Absorption of the hematoma after ventricular hemorrhage usually takes several weeks, and there are very few articles in the literature on hematoma absorption. As far as we know early spontaneous disappearance of spontaneous primary IVH has not previously been reported in the literature. Herein, we describe a rare case of spontaneous primary IVH that rapidly disappeared without surgical intervention. The patient, a 73-year-old male, was admitted to the hospital for "unclear speech for 16 hours". An initial head computed tomography (CT) scan showed significant accumulation of blood in both lateral ventricles, the third ventricle, midbrain aqueduct, and fourth ventricle, as well as acute hydrocephalus. The patient was conscious and did not undergo EVD treatment. After 24 hours, head CT re-examination showed that the accumulated blood had been significantly absorbed, and hydrocephalus had improved. Three days later, head CT re-examination showed that the accumulated blood in the ventricles had been absorbed, and the patient did not experience any discomfort. Following observation for a few more days, he was discharged from the hospital.
自发性原发性脑室内出血(IVH)是一种罕见的颅内出血类型,可集中于一个或多个脑室。出血后的临床症状多样,若有大量出血或脑积水,常需进行脑室外引流(EVD)治疗。脑室内出血后血肿吸收通常需要数周时间,而关于血肿吸收的文献报道很少。据我们所知,此前文献中尚未报道过自发性原发性IVH早期自发消失的情况。在此,我们描述一例罕见的自发性原发性IVH病例,该病例未经手术干预血肿迅速消失。患者为一名73岁男性,因“言语不清16小时”入院。最初的头部计算机断层扫描(CT)显示双侧脑室、第三脑室、中脑导水管和第四脑室内有大量血液积聚,以及急性脑积水。患者意识清醒,未接受EVD治疗。24小时后,头部CT复查显示积聚的血液已明显吸收,脑积水有所改善。三天后,头部CT复查显示脑室内积聚的血液已被吸收,患者未出现任何不适。经过几天的观察后,他出院了。