Intraventricular Hemorrhage


John M. Barkley
Denise Morales
L. Anne Hayman
Pedro J. Diaz-Marchan


The intraventricular space is a CSF-containing space within the paired lateral, third and fourth ventricles.

Intraventricular hemorrhage (IVH) may occur within any ventricle; however, often occurs in the lateral ventricles after trauma. It may be a primary event or secondary event such as extension from a parenchymal contusion or existing SAH. Primary IVH in the trauma patient is due to injury of the subependymal veins surrounding the ventricles.

As described for mixed subdural hematomas with blood–blood levels, the acute intraventricular hematoma will layer in the dependent portions of the ventricle in a supine patient. If the hemorrhage is within the lateral ventricle, the blood is often seen in the occipital horns posteriorly. It has been reported to occur in 35 percent of patients with moderate to severe brain injury (1, 2).

IVH may lead to a non-communicating hydrocephalus (described below) due to obstruction of CSF flow at the level of the foramina of Monro or the cerebral aqueduct (Figure 11-13).

Original: Brain Injury Medicine. Principles and Practice


  1. Harris, JH & Harris, WH. The Radiology of Emergency Medicine, 4th Edition. Philadelphia: Lippincott, Williams & Wilkins, 2000; Pg 1–49.

  2. Gentry LR. Imaging of closed head injury. Radiology 1994; 191: 1–17.