title: Ventriculostomy associated haemorrhage: a complication of anti-platelet therapy during coiling.
abstract: A young man with Fisher grade IV subarachnoid haemorrhage (SAH) underwent aneurysm coiling following external ventriculostomy. Coiling was complicated by thrombus formation and parent vessel occlusion necessitating anti-platelet therapy. Several hours after anti-platelet therapy, catastrophic haemorrhage associated with the ventriculostomy tract occurred. Timing and location of haemorrhage suggest combined anti-platelet therapy and ventriculostomy may have been causal. The literature on ventriculostomy haemorrhage rates and risks with concomitant anti-platelet therapy are reviewed. Where endovascular coiling is being considered, the possibility of ventriculostomy-related haemorrhage should be considered and should influence subsequent treatment decisions.
authors.affiliation: Department of Neurosurgery, University Hospital of North Staffordshire, City General Hospital , Stoke on Trent , UK.
authors.forename: Hugh P
authors.initials: HP
authors.lastname: Sims-Williams
authors.forename: Daniel
authors.initials: D
authors.lastname: Weinberg
authors.forename: Changez K
authors.initials: CK
authors.lastname: Jadun
authors.forename: Howard L
authors.initials: HL
authors.lastname: Brydon
mesh_terms: D000328:Adult; D057510:Endovascular Procedures / Q000009:adverse effects*; D006408:Hematoma, Subdural / Q000139:chemically induced / Q000209:etiology*; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy / Q000601:surgery*; D014696:Ventriculostomy / Q000009:adverse effects*
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: CSF shunt complication; aneurysmal SAH; anticoagulation; coiling; external ventricular drain; subdural haematoma; ventriculostomy associated haemorrhage