Isolated Fourth Ventricle Hemorrhage Following Minor Trauma: A Case Report

Abstract

Aim: Isolated fourth ventricle hemorrhage is an extremely rare clinical pathology and is usually associated with severe trauma. Ventricular hemorrhages are usually seen in the lateral ventricles and are often accompanied by cerebral contusions, skull fractures, or parenchymal hemorrhages. The fourth ventricle, which has an anatomical position surrounded by the brain stem and cerebellum, is less sensitive to trauma compared to other ventricles. Case Presentation: In this case report, a 3-year-old child was presented to the emergency department with a gait disturbance following a backward fall from a chair. The neurological examination of the patient was normal, except for a gait disturbance (ataxic gait). Cranial computed tomography (CT) imaging showed a hemorrhage of approximately 1 cm in the fourth ventricle. The patient was hospitalized for close follow-up and observation. After 12 hours, the gait disturbance had completely disappeared, and the hemorrhage had also resolved on the CT image. Conclusion: This case report highlights the recognition of isolated fourth ventricular hemorrhage in clinical practice, possible mechanisms underlying it, management strategies, and prognostic considerations in the context of pediatric trauma.