Traumatic aneurysm resulting from insertion of an intracranial pressure monitor

Le, Hoang; Munshi, Ilyas; Macdonald, R. Loch; Wollmann, Robert L.; Frank, Jeffrey I.

doi:10.3171/jns.2001.95.4.0720

Cited by 16 publications

(15 citation statements)

References 1 publication

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“…20 Different neurosurgical pro cedures have been reported to cause iatrogenic traumatic aneurysms: ventricular drain placement, 19 endoscopic third ventriculostomy, 8,9 excision of craniopharyngiomas, 22 or in tracranial pressure monitoring device placement. 12 In 1961 White and colleagues 21 reproduced in an animal model the formation of these traumatic lesions by puncturing intra cranial vessels in dogs; their anatomopathological results were similar to those found in human cases.…”

Section: Discussionsupporting

confidence: 54%

Acute subdural hematoma secondary to distal middle cerebral artery aneurysm rupture in a newborn infant

Iza-Vallejo

Sierra²,

Fortea-Gil

et al. 2009

PED

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Section: Discussionsupporting

confidence: 54%

Acute subdural hematoma secondary to distal middle cerebral artery aneurysm rupture in a newborn infant

Iza-Vallejo

Sierra²,

Fortea-Gil

et al. 2009

PED

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“…Published and anecdotal accounts serve to highlight the often times remarkable clinical and radiographic behaviors associated with these lesions 1 3. Histologically, these lesions are characterized by complete interruption of the vessel wall with intravascular blood retained by an extravascular hematoma 4…”

Section: Discussionmentioning

confidence: 99%

“…Hemorrhage after ‘bolt’ placement may occur in as many as 9.7% of patients, most commonly at the time of the procedure due to direct passage of the fiberoptic instrument through brain tissue 2. To our knowledge, there is only one other case in the literature that has described the formation of an iatrogenic intracranial pseudoaneurysm following placement of an ICP monitor 1. In this case, the hemorrhage was detected on a routine CT scan as the patient did not have any change in their neurologic examination.…”

Section: Discussionmentioning

confidence: 99%

“…In this case, the hemorrhage was detected on a routine CT scan as the patient did not have any change in their neurologic examination. The pseudoaneurysm was treated with craniotomy 1. The mechanism of injury was not precisely known.…”

Section: Discussionmentioning

confidence: 99%

“…Traumatic intracranial pseudoaneurysms account for less than 1% of all cerebral aneurysms 1. Among this uncommon subset, pseudoaneurysm formation following placement of an intracranial pressure (ICP) monitor is exceptionally rare 2.…”

Section: Introductionmentioning

confidence: 99%

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Republished: Intracranial pseudoaneurysm after intracranial pressure monitor placement

Shah

Jones

Arnold

et al. 2014

J NeuroIntervent Surg

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SUMMARYTraumatic intracranial pseudoaneurysms are a rare but severe complication following arterial injury. Pseudoaneurysm formation can occur secondary to blunt or penetrating trauma or iatrogenic injury. We report a case of traumatic pseudoaneurysm secondary to placement of an intracranial pressure (ICP) monitor. A 27-year-old man was involved in a motorcycle accident resulting in multiple intracranial hemorrhages. The patient underwent craniectomy and placement of an ICP monitor. 17 days later he developed dilation of his left pupil, with imaging demonstrating a new hemorrhage in the vicinity of the previous ICP monitor. A cerebral angiogram confirmed a left-sided distal M4 pseudoaneurysm which was treated by n-butyl cyanoacrylate embolization. Intracranial pseudoaneurysm formation following neurosurgical procedures is uncommon. Delayed intracranial hemorrhage in a region of prior intracranial manipulation, even following a procedure as 'routine' as placement of an ICP monitor, should raise the suspicion for this rare but potentially lethal complication. BACKGROUND

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Iatrogenic intracranial pseudoaneurysms: neuroradiological and therapeutical considerations, including endovascular options

et al. 2006

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Intracranial pseudoaneurysms represent a potentially fatal complication of intracranial surgery. Our purpose is to describe their neuroradiological characteristics, prognostic features and possible treatment. Eight cases of postsurgical intracranial pseudoaneurysms have been observed at our institution since 1988. Four were observed following transsphenoidal (TS) surgery and four after pterional craniotomies. Two types of iatrogenic pseudoaneurysms were observed: "fusiform", probably due to weakening of the adventitia during surgical peeling of the tumour from the artery (three cases) and "saccular", occurring after a more focal or complete laceration of the vessel (five cases), more often after TS surgery. A thorough preoperative neuroradiological examination may identify anatomical conditions at risk for development of this severe complication. Postoperative neuroradiological follow-up is mandatory in cases in which unusual bleeding has occurred during the perioperative period, but absence of bleeding does not exclude the possible development of a pseudoaneurysm. Endovascular treatment of pseudoaneurysms represents a safe and durable procedure, specifically in those cases in which damage to the carotid siphon occurred during TS surgery.

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Traumatic aneurysm resulting from insertion of an intracranial pressure monitor

Abstract: A fiberoptic intracranial pressure (ICP) monitor (microsensor bolt; Codman, Raynham, MA) was placed through a twist-drill hole into the right frontal region of a 30-year-old man who had sustained a severe, closed head injury. The dura mater was opened using an J Neurosurg 95:720, 2001

Cited by 16 publications

References 1 publication

Acute subdural hematoma secondary to distal middle cerebral artery aneurysm rupture in a newborn infant

Acute subdural hematoma secondary to distal middle cerebral artery aneurysm rupture in a newborn infant

Republished: Intracranial pseudoaneurysm after intracranial pressure monitor placement

Iatrogenic intracranial pseudoaneurysms: neuroradiological and therapeutical considerations, including endovascular options

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