Sudden Death due to Intraventricular Haemorrhage Masquerading as Alcohol Intoxication: A Case Report

Abstract

Intraventricular Haemorrhage (IVH) is the haemorrhage which occurs in the ventricular
system of the brain. Depending on the source of bleeding, IVH is divided into two types primary
and secondary Intraventricular Haemorrhage. Mostly primary Intraventricular Haemorrhage is
due to some pathological causes like degenerative changes in vessels, hypertension and
tumours especially that of choroid plexus, rarely can occurs as sole cause of death due to direct
injury to the cerebral vessels without any associated parenchymal haemorrhage. Here, i am
reporting a case of sudden death due to PIVH. Patient was admitted at GMCH, Chandigarh with
the alleged history of RSA while he was driving the vehicle hit and run over the person. Initially,
he was arrested by the local police and was thought to be under the influence of alcohol/some
drugs for which he was taken to local hospital for medical examination. But after some time he
became unconscious thus he was referred to higher centre. He was admitted in medicine
emergency in unconscious state, NCCT head showed haemorrhage in the ventricular system.
On postmortem examination and macroscopically shows only IVH without any traumatic or any
other intra parenchymal haemorrhage/injury. On further examination, it was confirmed that
source of bleeding is due to ruptured anterior communicating artery.
This case puts light on the importance of detailed examination especially in cases where
there is no external injury over the head but internally there can be fatal injury to brain
parenchyma or vasculature.