scholarly journals External Ventricular Drain Migration Causing Parinaud’s Syndrome: A Case Report

Cureus ◽  
2020 ◽  
Author(s):  
Christine Mau ◽  
Ira Goldstein
Keyword(s):  
Case Report ◽  
External Ventricular Drain ◽  
Parinaud’S Syndrome

scholarly journals Ruptured Bilateral Pericallosal Artery Aneurysm in Mirror Position: Case Report

2018 ◽  
Vol 37 (03) ◽  
pp. 263-266
Author(s):  
Lucas Meguins ◽  
Linoel Valsechi ◽  
Ronaldo Fernandes ◽  
Dionei Morais ◽  
Antonio Spotti
Keyword(s):  
Case Report ◽  
Subarachnoid Hemorrhage ◽  
External Ventricular Drain ◽  
Artery Aneurysm ◽  
Operative Management ◽  
Neurological Deficits ◽  
Pericallosal Artery ◽  
Digital Subtraction Arteriography ◽  
The Many ◽  
The Right

Introduction Pericallosal artery (PA) aneurysms represent 2 to 9% of all intracranial aneurysms, and their management remains difficult. Objective The aim of the present study is to describe the case of an adult woman with subarachnoid hemorrhage and bilateral PA aneurysm in mirror position. Case Report A 46-year-old woman was referred to our institution 20 days after a sudden severe headache. She informed that she was treating her arterial hypertension irregularly, and consumed ∼ 20 cigarettes/day. The patient was neurologically intact at admission. A non-contrast computed tomography (CT) on the first day of the onset of the symptoms revealed hydrocephaly and subarachnoid hemorrhage (Fisher III). An angio-CT/digital subtraction arteriography showed bilateral PA aneurysms in mirror position. The patient was successfully treated with surgery via the right interhemispheric approach (because the surgeon is right-handed); the surgeon performed the proximal control with temporary clipping, and introduced an external ventricular drain at the end of the surgery. The patient was discharged on the fourth postoperative day without any additional neurological deficits or ventricular shunts. Conclusion Ruptured PA aneurysm is a surgically challenging aneurysm due to the many anatomical nuances and risk of rebleeding. However, the operative management of ruptured bilateral PA aneurysms is feasible and effective.

scholarly journals Case Report: A case report of dry tap during ventriculostomy

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 188
Author(s):  
Sunil Munakomi ◽  
Binod Bhattarai
Keyword(s):  
Case Report ◽  
External Ventricular Drain ◽  
Foramen Of Monro ◽  
Shunt Insertion ◽  
Gradual Improvement ◽  
Vp Shunt ◽  
Tension Pneumocephalus ◽  
Frontal Horn ◽  
Increased Risk ◽  
Ventricular Puncture

Pneumocephalus following ventriculoperitoneal (VP) shunt insertion is an exceptionally rare occurrence. We report such an event after attempting ventricular puncture (ventriculostomy) for VP shunt insertion and then discuss the management of the same. Dry tap can lead to multiple attempts for ventriculostomy with the associated added risks of complications, as well as complicating the subsequent management. In addition, there is an increased risk of tension pneumocephalus, seizure and shunt failure due to a blockage by air bubbles. Our patient presented with features of raised intracranial pressure two months following craniotomy and evacuation of traumatic subdural hematoma. External ventricular puncture revealed egress of CSF under pressure. Upon attempting VP shunting for post-traumatic hydrocephalus, we experienced dry tap during ventricular puncture that complicated further management. We placed the proximal shunt in the presumed location of the foramen of Monro of ipsilateral frontal horn of lateral ventricle and did not remove the external ventricular drain. Post-operative CT scan revealed pneumoventriculi as the cause for the dry tap during ventricular puncture. Patient was managed with 100% oxygen. He showed gradual improvement and was later discharged. This case shows that variations in the procedure, including head down positioning, adequate cruciate dural incision prior to cortex puncture, and avoiding excessive egress of CSF can help to prevent such complications.

“MASSIVE BI-FRONTAL EXTRADURAL HEMORRHAGE FOLLOWING EXTERNAL VENTRICULAR DRAIN (EVD) PLACEMENT”-A CASE REPORT

2021 ◽  
pp. 46-47
Author(s):  
Ashim Kr Boro ◽  
Ashok Gupta ◽  
Arvind Kumar ◽  
Gitanshu Dahuja
Keyword(s):  
Intensive Care ◽  
Case Report ◽  
Ct Scan ◽  
External Ventricular Drain ◽  
Twist Drill ◽  
Pontine Glioma ◽  
Brainstem Tumor ◽  
Surgical Evacuation ◽  
Neurosurgical Intensive Care ◽  
Contrast Ct

One of the most important lifesaving procedures performed regularly in neurosurgical intensive care units is the insertion of an External Ventricular Drain (EVD).Complications arising from EVDs include hemorrhage, misplacement, dislodgement, blockage, and infection. We present a case of massive bi-frontal extradural hemorrhage following external ventricular drain (EVD) placement. A 23 years old male, diagnosed with dorsally exophytic midbrain and pontine glioma presented with headache, repeated vomiting and became drowsy. Non-contrast CT scan of head showed brainstem tumor with hydrocephalus. An EVD was inserted through right frontal twist drill craniostomy. Patient improved only to deteriorate 2 hours later. Repeat NCCT head showed massive bifrontal extradural hemorrhage. Immediate bi-frontal craniotomy and surgical evacuation of extradural hemorrhage was done. Complications of EVD insertions are many therefore preferably EVD insertion should be carried out in operation theratre and multiple attempts should be avoided, also controlled drainage of csf should be done.

External ventricular drain placement causing upgaze palsy: Case report

2013 ◽  
Vol 115 (8) ◽  
pp. 1514-1516 ◽  
Author(s):  
Benjamin P. Rosenbaum ◽  
Anne-Marie E. Wheeler ◽  
Ajit A. Krishnaney
Keyword(s):  
Case Report ◽  
External Ventricular Drain ◽  
Drain Placement

scholarly journals Successful Use of Ketamine for Central Neurogenic Hyperventilation: A Case Report

2017 ◽  
Vol 7 (4) ◽  
pp. 192-195 ◽  
Author(s):  
G. Morgan Jones ◽  
Adam L. Wiss ◽  
Nitin Goyal ◽  
Jason J. Chang
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Intracerebral Hemorrhage ◽  
Bolus Dose ◽  
External Ventricular Drain ◽  
Respiratory Pattern ◽  
Respiratory Drive ◽  
Aggressive Management ◽  
Intravenous Ketamine ◽  
Sedative Agents

This report describes the use of ketamine in a patient with central neurogenic hyperventilation following intracerebral hemorrhage. A 41-year-old man was admitted with right thalamic intracerebral hemorrhage with intraventricular extension requiring emergent external ventricular drain placement. After aggressive management of his neurologic status and other associated complications, the patient subacutely developed an altered respiratory pattern characterized by shallow, rapid breaths. After the use of multiple sedative agents to control respiratory drive had failed, a single 2 mg/kg bolus dose of intravenous ketamine was administered. In the 6 hours prior to ketamine dosing, respiratory rate ranged from 24 to 40 breaths per minute. Within minutes of ketamine administration, respiratory patterns improved and primarily ranged from 16 to 20. Twenty-four hours after ketamine administration, the patient was successfully extubated following 12 days of mechanical ventilation. Further research is needed to determine the widespread applicability of this strategy.

scholarly journals Case Report: A case report of dry tap during ventriculostomy

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 188
Author(s):  
Sunil Munakomi ◽  
Binod Bhattarai
Keyword(s):  
Case Report ◽  
External Ventricular Drain ◽  
Foramen Of Monro ◽  
Shunt Insertion ◽  
Gradual Improvement ◽  
Vp Shunt ◽  
Tension Pneumocephalus ◽  
Frontal Horn ◽  
Increased Risk ◽  
Ventricular Puncture

Pneumocephalus following ventriculoperitoneal (VP) shunt insertion is an exceptionally rare occurrence. We report such an event after attempting ventricular puncture (ventriculostomy) for VP shunt insertion and then discuss the management of the same. Dry tap can lead to multiple attempts for ventriculostomy with the associated added risks of complications, as well as complicating the subsequent management. In addition, there is an increased risk of tension pneumocephalus, seizure and shunt failure due to a blockage by air bubbles. Our patient presented with features of raised intracranial pressure two months following craniotomy and evacuation of traumatic subdural hematoma. External ventricular puncture revealed egress of CSF under pressure. Upon attempting VP shunting for post-traumatic hydrocephalus, we experienced dry tap during ventricular puncture that complicated further management. We placed the proximal shunt in the presumed location of the foramen of Monro of ipsilateral frontal horn of lateral ventricle and did not remove the external ventricular drain. Post-operative CT scan revealed pneumoventriculi as the cause for the dry tap during ventricular puncture. Patient was managed with 100% oxygen. He showed gradual improvement and was later discharged. This case shows that variations in the procedure, including head down positioning, adequate cruciate dural incision prior to cortex puncture, and avoiding excessive egress of CSF can help to prevent such complications.

Iatrogenic Intracranial Aneurysm After External Ventricular Drain Placement: Traumatic or Mycotic Origin? Case Report and Literature Review

2020 ◽  
Vol 143 ◽  
pp. 214-218
Author(s):  
Marta Pastor-Cabeza ◽  
Antonio González-Crespo ◽  
Manel Tardáguila ◽  
Alberto Blanco Ibañez de Opacua ◽  
Sebastián Remollo ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Intracranial Aneurysm ◽  
External Ventricular Drain ◽  
Drain Placement

scholarly journals Long-tunnelled external ventricular drain as a long-term treatment option for hydrocephalus in a child with an unresectable low-grade supratentorial tumor: case report

2016 ◽  
Vol 18 (4) ◽  
pp. 430-433
Author(s):  
John A. Emelifeonwu ◽  
Drahoslav Sokol ◽  
Pasquale Gallo ◽  
Jothy Kandasamy ◽  
Chandrasekaran Kaliaperumal
Keyword(s):  
Case Report ◽  
Treatment Option ◽  
Parental Education ◽  
External Ventricular Drain ◽  
Term Treatment ◽  
Low Grade ◽  
Management Option ◽  
Long Term Treatment ◽  
Viable Treatment

The authors report a case of a child with hypothalamic-origin pilocytic astrocytoma and hydrocephalus, which was refractory to treatment with a ventriculoperitoneal shunt due to high CSF protein content. With parental education, the child's hydrocephalus was managed long-term in the community with a long-tunnelled external ventricular drain, which was maintained by his parents. To the authors' knowledge this is the first report of this management option as a long-term measure. No harm has come to the patient. The authors propose long-term, long-tunnelled external ventricular drain as a viable treatment option for such patients.

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