Intracranial Hypertension Syndrome Secondary to Intraventricular Hemorrhage: A Case Report

Abstract

Introduction: Acute intracranial hypertension (ICH) syndrome is a neurosurgical emergency. Timely diagnosis of ICH is imperative for potential reversibility of the neurological condition. We report the case of a child with bleeding and hydrocephalus secondary to lateral ventricle injury, with an emphasis on the outcome secondary to ICH. Case Report: A 10-year-old girl presented to the emergency department with a history of progressive holocranial headache and vomiting for 1 day. She progressed with a progressive decrease in the level of consciousness. A computed tomography scan of the head was performed only 12 hours after admission, revealing intraventricular hemorrhage associated with calcifications and ventricular dilation. Upon admission to a specialized service, she had bilateral fixed mydriasis and the absence of brainstem reflexes. Emergency ventriculostomy was performed, but the patient developed brain death the following day. Conclusion: Besides the delay in diagnosis, the time between diagnosis and emergency neurosurgical treatment also constituted a significant factor in the unfavorable outcome described. In many ICH situations, a simple procedure like ventriculostomy can prevent an unfavorable outcome. Therefore, proper evaluation of pediatric patients and early recognition of clinical signs indicating intracranial hypertension are crucial for preventing an unfavorable and potentially fatal outcome.