title: Pontine infarction caused by medial branch injury of the basilar artery as a rare complication of cisternal drain placement.
abstract: We present a rare complication of cisternal drain placement during aneurysm surgery. A ruptured anterior communicating artery aneurysm was clipped through a right pterional approach. A cisternal drain was inserted from the retro-carotid to the prepontine cistern. Postoperatively, a left-sided paresis of the upper extremity had developed. A CT brain scan revealed that the drain was located between the pons and the basilar artery, resulting in a pontine infarction. Vascular neurosurgeons should keep this complication in mind when placing a cisternal drain tube. The drain tube should not be inserted too deep into the prepontine cistern.
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Nagano, Japan. tetuyosi@shinshu-u.ac.jp
authors.forename: Tetsuyoshi
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Yasunaga
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kuroiwa
authors.forename: Nunung Nur
authors.initials: NN
authors.lastname: Rahmah
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hongo
mesh_terms: D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery*; D001488:Basilar Artery / Q000473:pathology*; D020526:Brain Stem Infarctions / Q000209:etiology*; D002946:Cisterna Magna / Q000601:surgery; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011149:Pons / Q000473:pathology*; D013130:Spinal Stenosis / Q000150:complications; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D020246:Venous Thrombosis / Q000150:complications