Neuroanatomy Atlas in Clinical Context

VENTRICLES AND HEMORRHAGE INTO THE VENTRICLES 73

B

A

Epidural hematoma

Blood in brain

Blood in lateral ventricle

Blood in third ventricle

C

Blood in third ventricle

Blood in atrium of lateral ventricle

Subarachnoid blood on tentorium cerebelli

choroid plexus. In addition, blood from a ruptured aneurysm may prefer entially dissect into adjacent ventricular spaces as described in Figure 4-12. Intraventricular blood may also occur in newborns who have bleeding internal to the ependymal lining of the ventricle ( subependymal hemor rhage ) that extends into the ventricle, in a patient of any age who may bleed from an arteriovenous malformation, or from a highly vascular tumor of the choroid plexus within the ventricular space. As a general principle, the larger the ventricles become, in cases of intraventricular blood, the more serious the prognosis for the patient. These axial CT images ( A – C ) illustrate the important fact that, espe cially in patients with head trauma , blood may be found at different locations ( meningeal , intraventricular , within the substance of the brain [ parenchymatous ]) sometimes all in the same patient. Copyright © Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. 2024

4-13 Examples of blood in the ventricles resulting from head trauma and/or traumatic brain injuries (TBIs). Note the soft tissue damage and skull fractures (especially in patients A and B ). In patient A , there is blood in the right anterior horn of the lateral ventricle. Patient B has blood in the right anterior horn, in the third ventricle, and in the substance of the brain in the right frontal lobe, as well as a small epidural at the right frontal pole. Patient C has blood in the third ventricle and in the atrium of the lateral ventricle on the right side. In addition to trauma, as illustrated here, intraventricular hemorrhage (also called intra ventricular blood ) may occur in a variety of situations. Intracerebral hem orrhage is a bleed into the substance of the brain (also called parenchymal hemorrhage ). This blood extends into a ventricular space, arises from a brain tumor or from an arteriovenous malformation, or a tumor of the