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Intraventricular hemorrhage

Brett L Cucchiara, MD
Section Editor
Scott E Kasner, MD
Deputy Editor
Janet L Wilterdink, MD


Primary intraventricular hemorrhage (IVH) refers to bleeding confined to the ventricular system within the brain. Primary IVH is uncommon, accounting for only about 3 percent of all spontaneous intracerebral hemorrhage [1]. Intraventricular hemorrhage more commonly occurs in the setting of intracerebral hemorrhage or subarachnoid hemorrhage (secondary IVH).

The assessment of the patient with IVH focuses on identifying the underlying cause of the hemorrhage, which may have significant treatment implications. The distinction between primary and secondary IVH is critical in this regard. Common to patients with IVH, regardless of etiology, is a risk for sudden and potentially fatal obstructive hydrocephalus, requiring acute clinical decision-making regarding the use of external ventricular drainage and other interventions.

This topic discusses the causes, clinical presentation, diagnosis, and treatment of IVH. Intracerebral, subarachnoid, subdural, and epidural hemorrhage are discussed separately. (See "Spontaneous intracerebral hemorrhage: Pathogenesis, clinical features, and diagnosis" and "Spontaneous intracerebral hemorrhage: Treatment and prognosis" and "Clinical manifestations and diagnosis of aneurysmal subarachnoid hemorrhage" and "Treatment of aneurysmal subarachnoid hemorrhage" and "Subdural hematoma in adults: Etiology, clinical features, and diagnosis" and "Subdural hematoma in adults: Prognosis and management" and "Intracranial epidural hematoma in adults".)

Intraventricular hemorrhage in the newborn is also discussed separately. (See "Clinical manifestations and diagnosis of intraventricular hemorrhage in the newborn" and "Management and complications of intraventricular hemorrhage in the newborn".)


Primary IVH is uncommon, accounting for only about 3 percent of all spontaneous intracerebral hemorrhages [1]. The following demographic characteristics were reported in a 2008 review of published cases series of primary intraventricular hemorrhage (IVH) [2]:

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Literature review current through: Nov 2017. | This topic last updated: Aug 26, 2013.
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