title: Intracranial pseudoaneurysm after intracranial pressure monitor placement.
abstract: Traumatic 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.
authors.affiliation: Department of Neurosurgery, University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Kushal J
authors.initials: KJ
authors.lastname: Shah
authors.affiliation: Department of Neurosurgery, University of Kansas, Kansas City, Kansas, USA.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Jones
authors.affiliation: Department of Neurosurgery, University of Kansas, Kansas City, Kansas, USA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Arnold
authors.affiliation: Department of Neurosurgery, University of Kansas, Kansas City, Kansas, USA.
authors.forename: Koji
authors.initials: K
authors.lastname: Ebersole
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery*; D002533:Cerebral Angiography; D002983:Clinical Competence; D004621:Embolization, Therapeutic / Q000379:methods*; D016489:Head Injuries, Closed / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D007049:Iatrogenic Disease; D020300:Intracranial Hemorrhages / Q000517:prevention & control*; D007427:Intracranial Pressure; D008297:Male; D008991:Monitoring, Physiologic / Q000009:adverse effects / Q000295:instrumentation*; D016896:Treatment Outcome
keywords: Aneurysm; Complication; Hemorrhage; Intracranial Pressure; Vessel Wall