Pediatric Spontaneous Intracranial Hemorrhage (SICH) with unknown etiology in rural area

Background: Spontaneous intracranial haemorrhage (SICH) on paediatrics is a rare condition which usually doesn’t present specific sign and symptoms. Therefore, quick diagnosis followed by appropriate initial treatment is necessary to reduce morbidity and mortality rate.
Case Presentation: An 11-year-old boy was admitted to the ER (emergency room) with sudden altered mental status 2 hours prior to admission. According to his parents, he complains headache after playing with friends previously. No history of trauma was found. Non contras CT scan shows intracerebral haemorrhage in the left and right lateral periventricular of the posterior horn (Vol 0.77 cc) and intraventricular haemorrhage in all the ventricles. EVD (External Ventricular Drain) placement surgery was performed. After two weeks of hospitalization, he was allowed to go home without any neurological deficits, and continued follow up in outpatient unit.
Summary: Spontaneous intracranial bleeding in children have high mortality and morbidity rates, but children do not always have specific signs and symptoms. Therefore, a quick diagnosis accompanied by appropriate initial treatment is very necessary to reduce morbidity and mortality rate, such as those to reduce intracranial pressure.