{"id":"99ad31a4-b54f-4851-89b1-43291d9116aa","slug":"iatrogenic-cortical-pseudoaneurysm-following-ventriculoperitoneal-shunt-insertion-presenting-with-intraventricular-hemorrhage","title":"Iatrogenic cortical pseudoaneurysm following ventriculoperitoneal shunt insertion presenting with intraventricular hemorrhage","authors":["Leonard H. Verhey","Theresa A. Elder","Joseph G. Adel"],"abstract":"Background: Cerebral pseudoaneurysm formation associated with ventricular catheterization is an exceedingly rare complication that results from direct catheter-induced injury to a vessel. We report a case of intracerebral pseudoaneurysm formation associated with ventricular catheterization in a patient with hydrocephalus following aneurysmal subarachnoid hemorrhage. Case Description: The patient presented with aneurysmal subarachnoid hemorrhage and underwent partial endovascular embolization of the offending wide-necked basilar tip aneurysm with the plan for a Stage 2 stent-assisted coiling after initial recovery. Before discharge, a ventriculoperitoneal shunt (VPS) was placed for postaneurysmal hydrocephalus. Three weeks later, she presented with intraparenchymal and intraventricular hemorrhage. Angiography revealed a cortical aneurysm contiguous to the ventricular catheter of the VPS. She underwent microsurgical excision of the aneurysm, and a new VPS was placed after resolution of the intraventricular hemorrhage. She later underwent the second stage of the treatment and had an excellent neurological recovery to an independent state. Conclusion: Iatrogenic intracerebral pseudoaneurysm formation is an exceedingly rare complication of ventricular catheterization but is associated with significant mortality. Identifying a pseudoaneurysm in this context warrants prompt and definitive treatment with microsurgical or endovascular treatment.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/99ad31a4-b54f-4851-89b1-43291d9116aa/featured/hero-1781563781190.png","publishDate":"2019-09-13T00:00:00.000Z","doi":"10.25259/SNI_36_2019","categories":["Unique Case Observations","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/99ad31a4-b54f-4851-89b1-43291d9116aa/pdf"}