Traumatic Intraventricular Haemorrhage
Between January, 1980 and April, 1986, we had 701 patients who had cerebral concussion or intracranial organic lesions following acute head injury. Among 701 patients, 19 patients with traumatic intraventricular haemorrhage (IVH), who were admitted to our clinic 0.3 to 19 hours after onset (average, 1 hour), were the subjects of this study, and the findings of computerized tomography (CT) and clinical features were studied. Traumatic IVH caused by direct spread of blood from evident intracerebral haemorrhage was excluded from this study. Accordingly, traumatic IVH was found in 2.7% of the patients with acute head injury. Blood was found in various portion of the ventricles. Main sites of the blood was as follows: around the foramen of Monro, 6 patients; in the body and occipital horn of the lateral ventricles, 5 patients; solely in the occipital horn, 8 patients. The haemorrhage around the foramen of Monro, resulting from contusion of the ventral portion of the corpus callosum, septum pellucidum, and fornix, showed an interesting CT finding (Figure): The haemorrhage displayed a V- or Y-shaped pattern in 2 cases out of 6 cases, which gave us an impression of outflow of the blood from the structure around the foramen of Monro. Ventricular dilatation caused only by traumatic IVH in the acute stage was not seen in our series. Therefore, no ventricular drainage was performed for IVH. Intracranial co-existing lesions (viz. cerebral contusion, 14 patients; traumatic subarachnoid haemorrhage, 8 patients; acute epidural haematoma, 4 patients; acute subdural haematoma, 1 patient) were seen in 17 patients, and extracranial lesions (viz. facial contusion, 8 patients; fracture of bones in the extremities, 7 patients; fracture of the pelvis, 4 patients, etc.,) were seen in 13 patients, suggesting the external force was excessive.