• Rui Guo, Ruiqi Chen, Zhiyuan Yu, Xin Zhao, Chao You, Hao Li, and Lu Ma.
• Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
• World Neurosurg. 2020 Jan 1; 133: e121-e128.

BackgroundPrimary intraventricular hemorrhage (PIVH) is rare, and causes, characteristics, and outcomes remain unknown in children.MethodsWe retrospectively analyzed the clinical characteristics of patients 1 month to 21 years of age who were admitted to the hospital with PIVH over a 7-year period. PIVH was defined as bleeding confined to the ventricular system without parenchymal or subarachnoid hemorrhage involvement.ResultsOf 18 included patients, 55.6% were female, and mean age was 13.8 ± 6.0 years. The most common presenting symptoms were headache (77.8%) and vomiting (33.3%). In 15 patients (83.3%), known etiologies were diagnosed, including arteriovenous malformations (66.7%), moyamoya disease (11.1%), and aneurysms (5.6%). Idiopathic PIVH was the diagnosis in 3 patients (16.7%). Surgery was performed in 15 patients (83.3%), and 3 patients (16.7%) received conservative treatment. Four patients (28.6%) had an unfavorable outcome at discharge, and 3 patients (16.7%) had an unfavorable outcome at the 3-month follow-up. Higher Graeb score was associated with an unfavorable outcome in both short-term and long-term follow-up.ConclusionsArteriovenous malformations were diagnosed in most pediatric patients with PIVH. Specific surgical treatment of underlying etiologies should be required to increase clinical improvement. Children with a higher Graeb score at admission tended to have poor early and late outcomes.Copyright © 2019 Elsevier Inc. All rights reserved.

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