INTRODUCTION:
Primary Intraventricular Hemorrhage (PIVH) refers to bleeding that
occurs specifically within the ventricular system of the brain, without
any involvement or bleeding within the surrounding brain tissue. It is a
rare occurrence comprising approximately 3.1% of non-traumatic central
nervous system hemorrhages [1]. While there is some literature on
the etiology, clinical features, and management of PIVH in adults, the
understanding of this condition in the pediatric population is limited,
posing challenges in identifying its characteristics and developing
specific management protocols. Available reports suggest that
arteriovenous malformations, Moya Moya disease, and aneurysms are among
the commonly implicated causes in pediatric cases [2]. Surgery,
particularly the use of an External Ventricular Drain (EVD) to alleviate
intracranial pressure in case of acute hydrocephalus, remains the
primary approach documented in the literature [2]. Due to the
significant risks of mortality and neurological impairment associated
with primary intraventricular hemorrhage (PIVH), it is imperative to
thoroughly report and discuss the key features of this condition in the
pediatric population. In this context, we present a rare case of
isolated PIVH in the fourth ventricle observed in a 10-year-old boy.