Hypertensive primary intraventricular hemorrhage due to a phaeochromocytoma.
Primary intraventricular haemorrhage (IVH) is rare. We defined primary IVH as haemorrhage into the ventricles only as detected by computerized tomographic (CT) brain scan. This is in contrast with other intracerebral haemorrhages (e.g. basal ganglia/thalamic with intraventricular extension). The clinical condition of the patient ranges from minimal neurological deficits to coma/death. It also carries with it a poor prognosis of up to 80% when all four ventricles are involved. We present a 45-year-old Chinese female who presented with a hypertensive IVH which was managed successfully with ventricular drainage and intraventricular urokinase therapy. An adrenal phaeochromocytoma was diagnosed which was subsequently removed laparoscopically. The patient has recovered well in all aspects. This case report will discuss management of IVH and the importance of searching for secondary causes of hypertension.
Rajendra
Tiruchelvarayan
T
Department of Neurosurgery, National Neuroscience Institute (Singapore General Hospital Campus), Singapore. gnsrt@sgh.com.sg
Kumar
Krishan
K
Liang
Loh Hwai
LH
D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000175:diagnosis; D001794:Blood Pressure; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D002552:Cerebral Ventricles; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010673:Pheochromocytoma / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed