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
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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.
KeywordsClip-wrapping External ventricular drain Iatrogenic pseudoaneurysm rupture
Anterior cerebral artery
Computed tomography angiography
External ventricular drain
Glasgow Coma Scale
Posterior communicating artery
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.
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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