Iatrogenic pseudoaneurysm rupture of the anterior cerebral artery after placement of an external ventricular drain, treated with clip-wrapping: a case report and review of the literature

Authors

• Joshua S. Catapano, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.Follow
• Michaela Lee, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Damjan Veljanoski, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Alexander C. Whiting, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Scott Brigeman, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.Follow
• Clinton D. Morgan, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Mohamed A. Labib, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.Follow
• Andrew F. Ducruet, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.Follow
• Peter Nakaji, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA. Neuropub@barrowneuro.org.

Document Type

Article

Abstract

External ventricular drains (EVDs) are often placed emergently for patients with hydrocephalus, which carries a risk of hemorrhage. Rarely, rupture of a pseudoaneurysm originating from an EVD placement precipitates such a hemorrhage. An EVD was placed in a patient with a ruptured left posterior communicating artery aneurysm who later underwent endovascular coil embolization. On post-bleed day 20, a distal right anterior cerebral artery pseudoaneurysm along the EVD tract ruptured, which was successfully treated via clip-wrapping. Although EVD-associated pseudoaneurysms are rare, they have a high propensity for rupture. Early treatment of these lesions should be considered to prevent neurologic deterioration.

Keywords

Clip-wrapping, External ventricular drain, Iatrogenic pseudoaneurysm rupture

Medical Subject Headings

Aged; Aneurysm, False (diagnosis, etiology); Aneurysm, Ruptured (diagnosis, etiology); Circle of Willis (pathology); Drainage (adverse effects, instrumentation); Embolization, Therapeutic (adverse effects, instrumentation); Humans; Hydrocephalus (therapy); Iatrogenic Disease; Intracranial Aneurysm (diagnosis, etiology); Male; Surgical Instruments (adverse effects)

Publication Date

7-1-2019

Publication Title

Acta neurochirurgica

E-ISSN

0942-0940

Volume

161

Issue

7

First Page

1371

Last Page

1376

PubMed ID

31102006

Digital Object Identifier (DOI)

10.1007/s00701-019-03935-z

Recommended Citation

Catapano, Joshua S.; Lee, Michaela; Veljanoski, Damjan; Whiting, Alexander C.; Brigeman, Scott; Morgan, Clinton D.; Labib, Mohamed A.; Ducruet, Andrew F.; and Nakaji, Peter, "Iatrogenic pseudoaneurysm rupture of the anterior cerebral artery after placement of an external ventricular drain, treated with clip-wrapping: a case report and review of the literature" (2019). Translational Neuroscience. 2105.
https://scholar.barrowneuro.org/neurobiology/2105