“…We found more cases reported in the literature of traumatic occipital artery pseudoaneurysm, none of which were attributed to injury from tunneling for insertion of VPS catheter. [ 4 5 6 7 8 9 10 ] In almost all cases, disruption of the vessel wall caused by blunt trauma, allowing blood to leak into the surrounding tissues and form a pulsatile hematoma. Pseudoaneurysm lacks a fibrous wall and is contained by a surrounding shell of hematoma and the overlying scalp.…”
Section: Discussionmentioning
confidence: 99%
“…Only a handful of cases of traumatic occipital artery aneurysms are reported, but injury to the occipital artery leading to psudoaneurysm formation as a result of tunneling to pass the distal catheter of VPS is very rare. [ 4 5 6 7 8 9 10 ] Moreover, swelling of the aneurysm may disturb the shunt valve or catheter, interrupting spontaneous flow of the CSF leading to underdrainage which can significantly affect the patient. The authors report a case of traumatic extracranial pseudoaneurysm of the occipital artery following VPS procedure in an infant with a review of the literature.…”
Although ventriculoperitoneal shunt (VPS) is the most common procedure performed by pediatric neurosurgeons, it is still associated with frustrating complications, most common of which are obstruction and infection. Traumatic occipital artery pseudoaneurysm is a very rare complication of VPS procedure. To the best of our knowledge, there is no similar case reported in the English language literature. A 12-month-old patient suffered posthemorrhagic hydrocephalus of prematurity, and multiple other complications due to extreme prematurity, including immature lung disease, retinopathy of prematurity, necrotizing enterocolitis, bowel perforation, short bowel syndrome resulting in total parenteral nutrition-dependence, and hydrocephalus which was treated by insertion of VPS. Four weeks after the shunt, a slowly enlarging pulsatile swelling distal to the valve under the catheter altering the shunt function was noted. The swelling was diagnosed as a pseudoaneurysm of the occipital artery and treated by excision of the aneurysm. The child developed isolated dilated fourth ventricle, which was treated by endoscopic fourth ventriculostomy. Traumatic occipital artery pseudoaneurysm as a result of tunneling of VPS catheter is a very rare complication of VPS. Clinical and radiological imaging is diagnostic of the aneurysm. Surgical repair should be considered in such cases. This case report is aimed to raise the awareness among physicians about this rare complication.
“…We found more cases reported in the literature of traumatic occipital artery pseudoaneurysm, none of which were attributed to injury from tunneling for insertion of VPS catheter. [ 4 5 6 7 8 9 10 ] In almost all cases, disruption of the vessel wall caused by blunt trauma, allowing blood to leak into the surrounding tissues and form a pulsatile hematoma. Pseudoaneurysm lacks a fibrous wall and is contained by a surrounding shell of hematoma and the overlying scalp.…”
Section: Discussionmentioning
confidence: 99%
“…Only a handful of cases of traumatic occipital artery aneurysms are reported, but injury to the occipital artery leading to psudoaneurysm formation as a result of tunneling to pass the distal catheter of VPS is very rare. [ 4 5 6 7 8 9 10 ] Moreover, swelling of the aneurysm may disturb the shunt valve or catheter, interrupting spontaneous flow of the CSF leading to underdrainage which can significantly affect the patient. The authors report a case of traumatic extracranial pseudoaneurysm of the occipital artery following VPS procedure in an infant with a review of the literature.…”
Although ventriculoperitoneal shunt (VPS) is the most common procedure performed by pediatric neurosurgeons, it is still associated with frustrating complications, most common of which are obstruction and infection. Traumatic occipital artery pseudoaneurysm is a very rare complication of VPS procedure. To the best of our knowledge, there is no similar case reported in the English language literature. A 12-month-old patient suffered posthemorrhagic hydrocephalus of prematurity, and multiple other complications due to extreme prematurity, including immature lung disease, retinopathy of prematurity, necrotizing enterocolitis, bowel perforation, short bowel syndrome resulting in total parenteral nutrition-dependence, and hydrocephalus which was treated by insertion of VPS. Four weeks after the shunt, a slowly enlarging pulsatile swelling distal to the valve under the catheter altering the shunt function was noted. The swelling was diagnosed as a pseudoaneurysm of the occipital artery and treated by excision of the aneurysm. The child developed isolated dilated fourth ventricle, which was treated by endoscopic fourth ventriculostomy. Traumatic occipital artery pseudoaneurysm as a result of tunneling of VPS catheter is a very rare complication of VPS. Clinical and radiological imaging is diagnostic of the aneurysm. Surgical repair should be considered in such cases. This case report is aimed to raise the awareness among physicians about this rare complication.
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