{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:44:45Z","timestamp":1770115485892,"version":"3.49.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,1,20]]},"abstract":"\n BACKGROUND<\/jats:title>\n External ventricular drains (EVDs) provide an invaluable diagnostic method for accessing cerebrospinal fluid and therapeutically treating elevated intracranial pressure. Although complications including hemorrhage and infection have been well documented, the formation of iatrogenic pseudoaneurysms following EVD placement has rarely been reported. The authors present a case of this exceedingly rare complication of iatrogenic pseudoaneurysm formation following EVD placement.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n In this report, the authors document the formation of a pseudoaneurysm within the A4 segment of the anterior cerebral artery in a 77-year-old female following frontal EVD placement, which was promptly recognized and successfully embolized endovascularly. They discuss the suspected pathophysiology, given the literature citing similar complications, and the differing management strategies following the discovery of iatrogenic pseudoaneurysms.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Although rare, iatrogenic vascular injury following EVD placement or removal should not be overlooked. If hemorrhage following catheter placement or manipulation develops, suspicion for iatrogenic vascular injury should be high, and appropriate vascular imaging should be performed. As reported here, prompt treatment with endovascular embolization provides a safe and effective means to prevent future rupture and worsening hemorrhage. This case and the literature review emphasize the importance of rapid diagnosis of postprocedural pseudoaneurysm formation and treatment to prevent continued secondary brain injury.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24558<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24558","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T15:53:55Z","timestamp":1737388435000},"source":"Crossref","is-referenced-by-count":0,"title":["Iatrogenic pseudoaneurysm formation of the anterior cerebral artery following placement of an external ventricular drain: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Zein","family":"Al-Atrache","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Cooper University Health Care, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley","family":"Dennison","sequence":"additional","affiliation":[{"name":"College of Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel Fort Lauderdale, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazen","family":"Zaher","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Cooper University Health Care, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Santucci","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Cooper University Health Care, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A.","family":"Tonetti","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Cooper University Health Care, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"10","key":"bib1","series-title":"Cureus","first-page":"e10981","article-title":"External ventricular drain migration causing Parinaud\u2019s syndrome: a case report","volume":"12","author":"Mau","year":"2020","unstructured":"Mau CGoldstein I. External ventricular drain migration causing Parinaud\u2019s syndrome: a case report. Cureus. 2020;12(10):e10981."},{"key":"bib2","series-title":"Surg Neurol Int","first-page":"298","article-title":"Hemorrhagic complications after removal of an external ventricular drain: a case report and literature review","volume":"14","author":"Plakopitis","year":"2023","unstructured":"Plakopitis NThemistoklis KMelanis KSpartalis EPatrikelis PPapasilekas T. Hemorrhagic complications after removal of an external ventricular drain: a case report and literature review. Surg Neurol Int. 2023;14:298."},{"key":"bib3","series-title":"World Neurosurg","first-page":"214","article-title":"Iatrogenic intracranial aneurysm after external ventricular drain placement: traumatic or mycotic origin? Case report and literature review","volume":"143","author":"Pastor-Cabeza","year":"2020","unstructured":"Pastor-Cabeza MGonz\u00e1lez-Crespo ATard\u00e1guila M, et al. Iatrogenic intracranial aneurysm after external ventricular drain placement: traumatic or mycotic origin? Case report and literature review. World Neurosurg. 2020;143:214-218."},{"key":"bib4","series-title":"Interdiscip Perspect Infect Dis","first-page":"708531","article-title":"External ventricular drain infections: risk factors and outcome","volume":"2014","author":"Hagel","year":"2014","unstructured":"Hagel SBruns TPletz MWEngel CKalff REwald C. External ventricular drain infections: risk factors and outcome. Interdiscip Perspect Infect Dis. 2014;2014:708531."},{"issue":"8","key":"bib5","series-title":"Clin Neurol Neurosurg","first-page":"1514","article-title":"External ventricular drain placement causing upgaze palsy: case report","volume":"115","author":"Rosenbaum","year":"2013","unstructured":"Rosenbaum BPWheeler AMEKrishnaney AA. External ventricular drain placement causing upgaze palsy: case report. Clin Neurol Neurosurg. 2013;115(8):1514-1516."},{"issue":"3","key":"bib6","series-title":"Ann R Coll Surg Engl","first-page":"221","article-title":"Complication rates of external ventricular drain insertion by surgeons of different experience","volume":"100","author":"Yuen","year":"2018","unstructured":"Yuen JSelbi WMuquit SBerei T. Complication rates of external ventricular drain insertion by surgeons of different experience. Ann R Coll Surg Engl. 2018;100(3):221-225."},{"issue":"4","key":"bib7","series-title":"Turk Neurosurg","first-page":"561","article-title":"Coma due to malplaced external ventricular drain","volume":"23","author":"Chai","year":"2013","unstructured":"Chai FYFarizal FJegan T. Coma due to malplaced external ventricular drain. Turk Neurosurg. 2013;23(4):561-563."},{"issue":"7","key":"bib8","series-title":"Acta Neurochir (Wien)","first-page":"1377","article-title":"Diabetes insipidus\u2014an extremely rare complication from replacement of an external ventricular drain","volume":"161","author":"Kawsar","year":"2019","unstructured":"Kawsar KAInam MBWatts C. Diabetes insipidus\u2014an extremely rare complication from replacement of an external ventricular drain. Acta Neurochir (Wien). 2019;161(7):1377-1380."},{"issue":"5","key":"bib9","series-title":"Br J Neurosurg","first-page":"605","article-title":"A frontal external ventricular drain causing a third cranial nerve palsy","volume":"31","author":"Razak","year":"2017","unstructured":"Razak AAArzoglou V. A frontal external ventricular drain causing a third cranial nerve palsy. Br J Neurosurg. 2017;31(5):605-606."},{"issue":"2","key":"bib10","series-title":"J Korean Neurosurg Soc","first-page":"158","article-title":"Multiple intracranial calcifications as a complication of external ventricular drain placement","volume":"47","author":"Ji","year":"2010","unstructured":"Ji CAhn JG. Multiple intracranial calcifications as a complication of external ventricular drain placement. J Korean Neurosurg Soc. 2010;47(2):158-160."},{"issue":"2","key":"bib11","series-title":"Childs Nerv Syst","first-page":"237","article-title":"Massive life-threatening bifrontal epidural hematoma following placement of an external ventricular drain","volume":"32","author":"Dash","year":"2016","unstructured":"Dash CGurjar HGarg KSharma BSSingla R. Massive life-threatening bifrontal epidural hematoma following placement of an external ventricular drain. Childs Nerv Syst. 2016;32(2):237-239."},{"issue":"11","key":"bib12","series-title":"Int J Neurosci","first-page":"1166","article-title":"Subdural hematoma from an acquired dural arteriovenous fistula following external ventricular drain placement for subarachnoid hemorrhage","volume":"130","author":"Kerezoudis","year":"2020","unstructured":"Kerezoudis PSorenson TJKapurch JR, et al. Subdural hematoma from an acquired dural arteriovenous fistula following external ventricular drain placement for subarachnoid hemorrhage. Int J Neurosci. 2020;130(11):1166-1169."},{"key":"bib13","series-title":"World Neurosurg","first-page":"41","article-title":"Postprocedural complications of external ventricular drains: a meta-analysis evaluating the absolute risk of hemorrhages, infections, and revisions","volume":"171","author":"Mahto","year":"2023","unstructured":"Mahto NOwodunni OPOkakpu U, et al. 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J Pediatr Surg Case Rep. 2021;74:102016"},{"issue":"1","key":"bib19","series-title":"Neurosurg Focus","first-page":"e4","article-title":"Traumatic intracranial aneurysms","volume":"8","author":"Larson","year":"2000","unstructured":"Larson PSReisner AMorassutti DJAbdulhadi BHarpring JE. Traumatic intracranial aneurysms. Neurosurg Focus. 2000;8(1):e4."},{"issue":"1","key":"bib20","series-title":"J Neurol Neurosurg Psychiatry","first-page":"127","article-title":"Traumatic cerebral aneurysms. Clinical features and natural history","volume":"36","author":"Benoit","year":"1973","unstructured":"Benoit BGWortzman G. Traumatic cerebral aneurysms. Clinical features and natural history. J Neurol Neurosurg Psychiatry. 1973;36(1):127-138."},{"issue":"10","key":"bib1","series-title":"Cureus","first-page":"e10981","article-title":"External ventricular drain migration causing Parinaud\u2019s syndrome: a case report","volume":"12","author":"Mau","year":"2020","unstructured":"Mau CGoldstein I. External ventricular drain migration causing Parinaud\u2019s syndrome: a case report. Cureus. 2020;12(10):e10981."},{"key":"bib2","series-title":"Surg Neurol Int","first-page":"298","article-title":"Hemorrhagic complications after removal of an external ventricular drain: a case report and literature review","volume":"14","author":"Plakopitis","year":"2023","unstructured":"Plakopitis NThemistoklis KMelanis KSpartalis EPatrikelis PPapasilekas T. Hemorrhagic complications after removal of an external ventricular drain: a case report and literature review. Surg Neurol Int. 2023;14:298."},{"key":"bib3","series-title":"World Neurosurg","first-page":"214","article-title":"Iatrogenic intracranial aneurysm after external ventricular drain placement: traumatic or mycotic origin? Case report and literature review","volume":"143","author":"Pastor-Cabeza","year":"2020","unstructured":"Pastor-Cabeza MGonz\u00e1lez-Crespo ATard\u00e1guila M, et al. Iatrogenic intracranial aneurysm after external ventricular drain placement: traumatic or mycotic origin? Case report and literature review. World Neurosurg. 2020;143:214-218."},{"key":"bib4","series-title":"Interdiscip Perspect Infect Dis","first-page":"708531","article-title":"External ventricular drain infections: risk factors and outcome","volume":"2014","author":"Hagel","year":"2014","unstructured":"Hagel SBruns TPletz MWEngel CKalff REwald C. External ventricular drain infections: risk factors and outcome. Interdiscip Perspect Infect Dis. 2014;2014:708531."},{"issue":"8","key":"bib5","series-title":"Clin Neurol Neurosurg","first-page":"1514","article-title":"External ventricular drain placement causing upgaze palsy: case report","volume":"115","author":"Rosenbaum","year":"2013","unstructured":"Rosenbaum BPWheeler AMEKrishnaney AA. External ventricular drain placement causing upgaze palsy: case report. Clin Neurol Neurosurg. 2013;115(8):1514-1516."},{"issue":"3","key":"bib6","series-title":"Ann R Coll Surg Engl","first-page":"221","article-title":"Complication rates of external ventricular drain insertion by surgeons of different experience","volume":"100","author":"Yuen","year":"2018","unstructured":"Yuen JSelbi WMuquit SBerei T. Complication rates of external ventricular drain insertion by surgeons of different experience. Ann R Coll Surg Engl. 2018;100(3):221-225."},{"issue":"4","key":"bib7","series-title":"Turk Neurosurg","first-page":"561","article-title":"Coma due to malplaced external ventricular drain","volume":"23","author":"Chai","year":"2013","unstructured":"Chai FYFarizal FJegan T. Coma due to malplaced external ventricular drain. Turk Neurosurg. 2013;23(4):561-563."},{"issue":"7","key":"bib8","series-title":"Acta Neurochir (Wien)","first-page":"1377","article-title":"Diabetes insipidus\u2014an extremely rare complication from replacement of an external ventricular drain","volume":"161","author":"Kawsar","year":"2019","unstructured":"Kawsar KAInam MBWatts C. Diabetes insipidus\u2014an extremely rare complication from replacement of an external ventricular drain. Acta Neurochir (Wien). 2019;161(7):1377-1380."},{"issue":"5","key":"bib9","series-title":"Br J Neurosurg","first-page":"605","article-title":"A frontal external ventricular drain causing a third cranial nerve palsy","volume":"31","author":"Razak","year":"2017","unstructured":"Razak AAArzoglou V. A frontal external ventricular drain causing a third cranial nerve palsy. Br J Neurosurg. 2017;31(5):605-606."},{"issue":"2","key":"bib10","series-title":"J Korean Neurosurg Soc","first-page":"158","article-title":"Multiple intracranial calcifications as a complication of external ventricular drain placement","volume":"47","author":"Ji","year":"2010","unstructured":"Ji CAhn JG. Multiple intracranial calcifications as a complication of external ventricular drain placement. J Korean Neurosurg Soc. 2010;47(2):158-160."},{"issue":"2","key":"bib11","series-title":"Childs Nerv Syst","first-page":"237","article-title":"Massive life-threatening bifrontal epidural hematoma following placement of an external ventricular drain","volume":"32","author":"Dash","year":"2016","unstructured":"Dash CGurjar HGarg KSharma BSSingla R. Massive life-threatening bifrontal epidural hematoma following placement of an external ventricular drain. Childs Nerv Syst. 2016;32(2):237-239."},{"issue":"11","key":"bib12","series-title":"Int J Neurosci","first-page":"1166","article-title":"Subdural hematoma from an acquired dural arteriovenous fistula following external ventricular drain placement for subarachnoid hemorrhage","volume":"130","author":"Kerezoudis","year":"2020","unstructured":"Kerezoudis PSorenson TJKapurch JR, et al. Subdural hematoma from an acquired dural arteriovenous fistula following external ventricular drain placement for subarachnoid hemorrhage. Int J Neurosci. 2020;130(11):1166-1169."},{"key":"bib13","series-title":"World Neurosurg","first-page":"41","article-title":"Postprocedural complications of external ventricular drains: a meta-analysis evaluating the absolute risk of hemorrhages, infections, and revisions","volume":"171","author":"Mahto","year":"2023","unstructured":"Mahto NOwodunni OPOkakpu U, et al. 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Oper Neurosurg (Hagerstown). 2016;12(1):77-82."},{"issue":"7","key":"bib15","series-title":"Acta Neurochir (Wien)","first-page":"1371","article-title":"Iatrogenic pseudoaneurysm rupture of the anterior cerebral artery after placement of an external ventricular drain, treated with clip-wrapping: a case report and review of the literature","volume":"161","author":"Catapano","year":"2019","unstructured":"Catapano JSLee MVeljanoski D, et al. Iatrogenic pseudoaneurysm rupture of the anterior cerebral artery after placement of an external ventricular drain, treated with clip-wrapping: a case report and review of the literature. Acta Neurochir (Wien). 2019;161(7):1371-1376."},{"key":"bib16","series-title":"Front Neurol","first-page":"582","article-title":"Intracranial pseudoaneurysms: evaluation and management","volume":"11","author":"Zheng","year":"2020","unstructured":"Zheng YLu ZShen JXu F. Intracranial pseudoaneurysms: evaluation and management. 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