Acta Neurochirurgica

, Volume 161, Issue 7, pp 1371–1376 | Cite as

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
Part of the following topical collections:
  1. Neurosurgery general


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 



Anterior cerebral artery


Computed tomography


Computed tomography angiography


External ventricular drain


Glasgow Coma Scale


Post-bleed day


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.

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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