Bloody Ventriculography: Intracerebral Hemorrhage Artistically Casting the Ventricular System's Anatomy Into a Bird's Head

Abstract

Causes of intracerebral hemorrhage are mostly attributed to vascular anomalies or hypertension. It causes significant morbidity and mortality worldwide. This illustrative case report presents an interesting computed tomography image of hyperacute basal ganglia hemorrhage with intraventricular extension artistically casting the ventricular system. The intraventricular hemorrhage was moderate upon presentation; the blood had delineated the anatomic details of the ventricular system. It closely resembles a Crax rubra's head in the sagittal view. We believe that this radiographic finding is not seen frequently, especially early in the course of the condition. However, it could serve as an intriguing and reproducible sign of the radiographic anatomy of the ventricular system.

Keywords: basal ganglia hemorrhage; computed tomography; hydrocephalus; hypertension; intraventricular hematoma; radiographic anatomy.

Figure 1. Non-contrast CT image of the brain, sagittal view.

The labeled hyperdense area is a right-sided intraparenchymal hematoma casting the ventricular system and outlining the details of its anatomy [12].

Figure 2. Crax rubra.

A photograph by Zinn, N. (2020). Great Curassow (Crax rubra) 2048×1638 [17] with permission.

Figure 3. Crax rubra sign.

Illustrated non-contrast CT brain image sagittal view of a right-sided intraparenchymal hematoma matching the transparent sketch of Crax rubra bird. The head crest fans out the lateral ventricle, the eye is precisely situated in the interthalamic adhesion, and the bird’s peak spans the third ventricle from every angle. The word “rubra” means red in Latin which conveniently describes the blood-filled cerebrospinal fluid (CSF) spaces in intraventricular hemorrhage (IVH).