Spontaneous Thrombosis Of Cerebral Aneurysms

Abstract

We have presented a case of spontaneous intracerebral hemorrhage with intraventricular extension in a 55-year-old hypertensive Negro male. The intraventricular clot was originally demonstrated by pneumoencephalography, and spontaneous lysis was evident in a follow-up air study 2 months later. No operative therapy was undertaken and the patient’s neurological status progressed from initial hemiplegia, hemihypesthesia and homonymous hemianopsia to mild paresis and sensory deficits 4 months after the ictus. The literature on intraventricular hemorrhage has been reviewed; this case and that of Ojemann and New contrast with the poor prognosis usually given to intraventricular extensions of spontaneous intracerebral hemorrhages. Progression of neurological signs or failure to improve, rather than simply the presence of an intraventricular clot, should determine the need for operative intervention. (Permission to reproduce case report denied by publisher.)