Endovascular management of ventricular catheter-induced anterior cerebral artery false aneurysm: technical case report.
OBJECTIVE
We describe the case of a 3.3-kg infant who developed an anterior cerebral artery pseudoaneurysm after ventricular catheter placement. The lesion was treated with endovascular vessel sacrifice.


METHODS
A 3.3-kg infant with a myelomeningocele underwent repair and ventricular catheter insertion for hydrocephalus. During shunt insertion, intracerebral arterial bleeding was encountered. Subsequent arteriography demonstrated an anterior cerebral artery pseudoaneurysm.


METHODS
Via a transfemoral artery approach, the aneurysm and feeding vessel were catheterized with a microcatheter and wire. The aneurysm and vessel were then sacrificed with detachable platinum coils.


CONCLUSIONS
Arterial injury is uncommon after ventricular catheter placement. When it does occur, however, an unstable pseudoaneurysm may form. Endovascular techniques can be used to remedy this problem, thus at times obviating the need for a standard craniotomy, which can be particularly difficult in a newborn.
Horowitz
Michael
M
Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. horowitzmb@upmc.edu
Sharts
Michael
M
Levy
Elad
E
Albright
A Leland
AL
Pollack
Ian
I
D000792:Angiography / Q000379:methods; D020771:Anterior Cerebral Artery / Q000473:pathology; D002404:Catheterization / Q000009:adverse effects*; D004621:Embolization, Therapeutic; D006801:Humans; D007231:Infant, Newborn; D002532:Intracranial Aneurysm / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008591:Meningomyelocele / Q000628:therapy; D014057:Tomography, X-Ray Computed / Q000379:methods