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
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.
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)
Digital Object Identifier (DOI)
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.