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Sir, A 61-year-old female had an episode of headache lasting for three days. Findings upon physical examination were negative except for progressive disorientation. A computer tomography (CT) scan revealed intraventricular hematoma (IVH) in the left trigone and occipital horn, and hydrocephalus [Figure 1a] and blood clots in the aqueduct [Figure 1b]. As we suspected the presence of subarachnoid hemorrhage (SAH), we planned for an immediate magnetic resonance imaging (MRI). There was a waiting period for approximately 50 min between the initial CT scan and acquiring the MRI. During this period the patient was kept quiet in bed. MRI T1-weighted images done after 50 min of the initial CT scan showed temporal horn of the left lateral ventricle filled with a clot exhibiting high signal intensity [Figure 1c]. MR images also revealed the resolution of hydrocephalus [Figure 1d]. After MR imaging, she was more alert relieved of headache. No vascular anomaly was detected on MR angiography. She was discharged without neurological deficit.

Rapid resolution of hydrocephalus due to simultaneous movements of hematoma in the trigono-occipital horn and the aqueduct