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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

  • Joshua S. Catapano
  • Michaela Lee
  • Damjan Veljanoski
  • Alexander C. Whiting
  • Scott Brigeman
  • Clinton D. Morgan
  • Mohamed A. Labib
  • Andrew F. Ducruet
  • Peter NakajiEmail author
Case Report - Neurosurgery general
  • 5 Downloads
Part of the following topical collections:
  1. Neurosurgery general

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 

Abbreviations

ACA

Anterior cerebral artery

CT

Computed tomography

CTA

Computed tomography angiography

EVD

External ventricular drain

GCS

Glasgow Coma Scale

PBD

Post-bleed day

PCoA

Posterior communicating artery

Notes

Acknowledgments

The authors thank the Neuroscience Publications staff at Barrow Neurological Institute for their help with the manuscript preparation.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Patient consent

The current case report was exempt from IRB review, and consent for the report was obtained by a medical power of attorney.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Joshua S. Catapano
    • 1
  • Michaela Lee
    • 1
  • Damjan Veljanoski
    • 1
  • Alexander C. Whiting
    • 1
  • Scott Brigeman
    • 1
  • Clinton D. Morgan
    • 1
  • Mohamed A. Labib
    • 1
  • Andrew F. Ducruet
    • 1
  • Peter Nakaji
    • 1
    Email author
  1. 1.Department of Neurosurgery, Barrow Neurological InstituteSt. Joseph’s Hospital and Medical CenterPhoenixUSA

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