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