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01-07-2019 | Hydrocephalus | Case Report - Neurosurgery general

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, Michaela Lee, Damjan Veljanoski, Alexander C. Whiting, Scott Brigeman, Clinton D. Morgan, Mohamed A. Labib, Andrew F. Ducruet, Peter Nakaji

Published in: Acta Neurochirurgica | Issue 7/2019

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.

Anderson RC, Kan P, Klimo P, Brockmeyer DL, Walker ML, Kestle JR (2004) Complications of intracranial pressure monitoring in children with head trauma. J Neurosurg 101:53–58PubMed

Chen Z, Zhang J, Miao H, Niu Y, Feng H, Zhu G (2013) Delayed rupture of iatrogenic cerebral pseudoaneurysms after neurosurgical procedures: report of two cases. Clin Neurol Neurosurg 115:1552–1554CrossRefPubMed

Choudhri O, Gupta M, Feroze AH, Heit JJ, Do HM (2014) Endovascular management of external ventricular drain-associated cerebrovascular injuries. Surg Neurol Int 5:167CrossRefPubMedPubMedCentral

Figueiredo EG, Foroni L, Monaco BA, Gomes MQ, Sterman Neto H, Teixeira MJ (2010) The clip-wrap technique in the treatment of intracranial unclippable aneurysms. Arq Neuropsiquiatr 68:115–118CrossRefPubMed

Foreman PM, Hendrix P, Griessenauer CJ, Schmalz PG, Harrigan MR (2015) External ventricular drain placement in the intensive care unit versus operating room: evaluation of complications and accuracy. Clin Neurol Neurosurg 128:94–100CrossRefPubMed

Huyette DR, Turnbow BJ, Kaufman C, Vaslow DF, Whiting BB, Oh MY (2008) Accuracy of the freehand pass technique for ventriculostomy catheter placement: retrospective assessment using computed tomography scans. J Neurosurg 108:88–91CrossRefPubMed

Jenkinson MD, Basu S, Broome JC, Eldridge PR, Buxton N (2006) Traumatic cerebral aneurysm formation following ventriculoperitoneal shunt insertion. Childs Nerv Syst 22:193–196CrossRefPubMed

Kakarla UK, Kim LJ, Chang SW, Theodore N, Spetzler RF (2008) Safety and accuracy of bedside external ventricular drain placement. Neurosurgery 63:ONS162–166; discussion ONS166-167PubMed

Khanna RK, Rosenblum ML, Rock JP, Malik GM (1995) Prolonged external ventricular drainage with percutaneous long-tunnel ventriculostomies. J Neurosurg 83:791–794CrossRefPubMed

10.

Ko JK, Cha SH, Choi BK, Lee JI, Yun EY, Choi CH (2014) Hemorrhage rates associated with two methods of ventriculostomy: external ventricular drainage vs. ventriculoperitoneal shunt procedure. Neurol Med Chir (Tokyo) 54:545–551CrossRef

11.

Kosty J, Pukenas B, Smith M, Storm PB, Zager E, Stiefel M, Leroux P, Hurst R (2013) Iatrogenic vascular complications associated with external ventricular drain placement: a report of 8 cases and review of the literature. Neurosurgery 72:ons208–ons213 discussion ons213PubMed

12.

Krotz M, Linsenmaier U, Kanz KG, Pfeifer KJ, Mutschler W, Reiser M (2004) Evaluation of minimally invasive percutaneous CT-controlled ventriculostomy in patients with severe head trauma. Eur Radiol 14:227–233CrossRefPubMed

13.

Kung DK, Policeni BA, Capuano AW, Rossen JD, Jabbour PM, Torner JC, Howard MA, Hasan D (2011) Risk of ventriculostomy-related hemorrhage in patients with acutely ruptured aneurysms treated using stent-assisted coiling. J Neurosurg 114:1021–1027CrossRefPubMed

14.

Leung GK, Ng KB, Taw BB, Fan YW (2007) Extended subcutaneous tunnelling technique for external ventricular drainage. Br J Neurosurg 21:359–364CrossRefPubMed

15.

Maniker AH, Vaynman AY, Karimi RJ, Sabit AO, Holland B (2006) Hemorrhagic complications of external ventricular drainage. Neurosurgery 59:ONS419–ONS424 discussion ONS424-415PubMed

16.

Miller C, Tummala RP (2017) Risk factors for hemorrhage associated with external ventricular drain placement and removal. J Neurosurg 126:289–297CrossRefPubMed

17.

Narayan RK, Kishore PR, Becker DP, Ward JD, Enas GG, Greenberg RP, Domingues Da Silva A, Lipper MH, Choi SC, Mayhall CG, Lutz HA 3rd, Young HF (1982) Intracranial pressure: to monitor or not to monitor? a review of our experience with severe head injury. J Neurosurg 56:650–659CrossRefPubMed

18.

North B, Reilly P (1986) Comparison among three methods of intracranial pressure recording. Neurosurgery 18:730–732CrossRefPubMed

19.

O’Leary ST, Kole MK, Hoover DA, Hysell SE, Thomas A, Shaffrey CI (2000) Efficacy of the Ghajar Guide revisited: a prospective study. J Neurosurg 92:801–803CrossRefPubMed

20.

Paramore CG, Turner DA (1994) Relative risks of ventriculostomy infection and morbidity. Acta Neurochir 127:79–84CrossRefPubMed

21.

Park YG, Woo HJ, Kim E, Park J (2011) Accuracy and safety of bedside external ventricular drain placement at two different cranial sites: Kocher’s point versus forehead. J Korean Neurosurg Soc 50:317–321CrossRefPubMedPubMedCentral

22.

Phillips SB, Delly F, Nelson C, Krishnamurthy S (2014) Bedside external ventricular drain placement: can multiple passes be predicted on the computed tomography scan before the procedure? World Neurosurg 82:739–744CrossRefPubMed

23.

Raygor KP, Mooney MA, Snyder LA, Levitt MR, Albuquerque FC, Spetzler RF (2016) Pseudoaneurysm of distal anterior cerebral artery branch following external ventricular drain placement. Oper Neurosurg (Hagerstown) 12:77–82CrossRef

24.

Roitberg BZ, Khan N, Alp MS, Hersonskey T, Charbel FT, Ausman JI (2001) Bedside external ventricular drain placement for the treatment of acute hydrocephalus. Br J Neurosurg 15:324–327CrossRefPubMed

25.

Ross IB, Dhillon GS (2003) Ventriculostomy-related cerebral hemorrhages after endovascular aneurysm treatment. AJNR Am J Neuroradiol 24:1528–1531PubMed

26.

Saladino A, White JB, Wijdicks EF, Lanzino G (2009) Malplacement of ventricular catheters by neurosurgeons: a single institution experience. Neurocrit Care 10:248–252CrossRefPubMed

27.

Schodel P, Proescholdt M, Ullrich OW, Brawanski A, Schebesch KM (2012) An outcome analysis of two different procedures of burr-hole trephine and external ventricular drainage in acute hydrocephalus. J Clin Neurosci 19:267–270CrossRefPubMed

28.

Scholz C, Hubbe U, Deininger M, Deininger MH (2013) Hemorrhage rates of external ventricular drain (EVD), intracranial pressure gauge (ICP) or combined EVD and ICP gauge placement within 48 h of endovascular coil embolization of cerebral aneurysms. Clin Neurol Neurosurg 115:1399–1402CrossRefPubMed

29.

Shirane R, Kondo T, Yoshida YK, Furuta S, Yoshimoto T (1999) Ruptured cerebral pseudoaneurysm caused by the removal of a ventricular catheter. Case report. J Neurosurg 91:1031–1033CrossRefPubMed

30.

Sussman ES, Kellner CP, Nelson E, McDowell MM, Bruce SS, Bruce RA, Zhuang Z, Connolly ES Jr (2014) Hemorrhagic complications of ventriculostomy: incidence and predictors in patients with intracerebral hemorrhage. J Neurosurg 120:931–936CrossRefPubMed

31.

Wiesmann M, Mayer TE (2001) Intracranial bleeding rates associated with two methods of external ventricular drainage. J Clin Neurosci 8:126–128CrossRefPubMed

Title: 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
Michaela Lee
Damjan Veljanoski
Alexander C. Whiting
Scott Brigeman
Clinton D. Morgan
Mohamed A. Labib
Andrew F. Ducruet
Peter Nakaji
Publication date: 01-07-2019
Publisher: Springer Vienna
Keywords: Hydrocephalus
Aneurysm
Aneurysm
Hydrocephalus
Hydrocephalus
CT Angiography
Published in: Acta Neurochirurgica / Issue 7/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-019-03935-z

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

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

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

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