Pseudoaneurysm of Distal Anterior Cerebral Artery Branch Following External Ventricular Drain Placement.
BACKGROUND: External ventricular drains (EVDs) are routinely placed as part of the management of intracranial hypertension. Pseudoaneurysm formation after EVD placement is a rare complication that can occur as a result of direct trauma to the cerebral vasculature. Prompt recognition and treatment may prevent future rupture.
OBJECTIVE: To present our management strategy of a unique case of pseudoaneurysm formation in the context of the medical literature on these rare complications.
METHODS: An EVD was placed in a 58-year-old female patient who presented with intracranial hypertension after subarachnoid hemorrhage secondary to a ruptured posterior communicating artery aneurysm before coiling of the aneurysm. On postbleed day 10, a pseudoaneurysm was identified in the distal anterior cerebral artery adjacent to the EVD tract.
RESULTS: The pseudoaneurysm was successfully treated with surgical resection.
CONCLUSION: Pseudoaneurysm formation after EVD placement is a rare but serious complication. We do not recommend routine screening for this complication; however, further investigation may be warranted when a delayed EVD tract hemorrhage is encountered. Prompt treatment of pseudoaneurysms is necessary to prevent future hemorrhage.
Oper Neurosurg (Hagerstown)
Digital Object Identifier (DOI)
Raygor, Kunal P; Mooney, Michael A; Snyder, Laura A; Levitt, Michael R; Albuquerque, Felipe C.; and Spetzler, Robert F, "Pseudoaneurysm of Distal Anterior Cerebral Artery Branch Following External Ventricular Drain Placement." (2016). Neurosurgery Articles. 731.