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Media type:
E-Article
Title:
Iatrogenic cortical pseudoaneurysm following ventriculoperitoneal shunt insertion presenting with intraventricular hemorrhage
Contributor:
Verhey, Leonard H.;
Elder, Theresa A.;
Adel, Joseph G.
Published:
Scientific Scholar, 2019
Published in:
Surgical Neurology International, 10 (2019), Seite 179
Language:
English
DOI:
10.25259/sni_36_2019
ISSN:
2152-7806
Origination:
Footnote:
Description:
Background:Cerebral pseudoaneurysm formation associated with ventricular catheterization is an exceedingly rare complication that results from direct catheter-induced injury to a vessel. We report a case of intracerebral pseudoaneurysm formation associated with ventricular catheterization in a patient with hydrocephalus following aneurysmal subarachnoid hemorrhage.Case Description:The patient presented with aneurysmal subarachnoid hemorrhage and underwent partial endovascular embolization of the offending wide-necked basilar tip aneurysm with the plan for a Stage 2 stent-assisted coiling after initial recovery. Before discharge, a ventriculoperitoneal shunt (VPS) was placed for postaneurysmal hydrocephalus. Three weeks later, she presented with intraparenchymal and intraventricular hemorrhage. Angiography revealed a cortical aneurysm contiguous to the ventricular catheter of the VPS. She underwent microsurgical excision of the aneurysm, and a new VPS was placed after resolution of the intraventricular hemorrhage. She later underwent the second stage of the treatment and had an excellent neurological recovery to an independent state.Conclusion:Iatrogenic intracerebral pseudoaneurysm formation is an exceedingly rare complication of ventricular catheterization but is associated with significant mortality. Identifying a pseudoaneurysm in this context warrants prompt and definitive treatment with microsurgical or endovascular treatment.