{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:06:36Z","timestamp":1784073996045,"version":"3.55.0"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"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 Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,7,13]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Intracranial pressure monitors (IPMs) are commonly placed in patients with severe traumatic brain injury to diagnose and guide treatment for intracranial hypertension. Complications of IPM placement include infection, hemorrhage, and malposition. While rare case reports describe ruptured iatrogenic pseudoaneurysms associated with IPM, the incidence and implications of unruptured pseudoaneurysms are poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 19-year-old female sustained a severe traumatic brain injury, leading to IPM placement. After a prolonged hospital course, delayed noninvasive imaging to characterize potential cerebrovascular injury raised concern for a carotid-cavernous fistula. Digital subtraction angiography (DSA) ruled out this pathology but revealed an unruptured distal right anterior cerebral artery pseudoaneurysm at the site of the previously placed IPM, which was later successfully treated with endovascular embolization after short-interval repeat DSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>While pseudoaneurysm formation is a rarely described complication of ICM placement, they are associated with a high rate of rupture (60%) and, subsequently, high mortality (20%). Thus, a high index of suspicion of potential pseudoaneurysm rupture should be maintained in the setting of a delayed rapid decline in neurological examination or delayed intraparenchymal hemorrhage after IPM placement. Urgent evaluation using CT angiography and\/or catheter angiography should be considered in addition to standard noncontrast imaging.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE251022\">https:\/\/thejns.org\/doi\/10.3171\/CASE251022<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case251022","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:15Z","timestamp":1784073615000},"source":"Crossref","is-referenced-by-count":0,"title":["Unruptured distal anterior cerebral artery branch pseudoaneurysm in the setting of intracranial pressure monitor placement: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3151-8211","authenticated-orcid":true,"given":"Andrew L.","family":"Waack","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina N.","family":"Feller","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard A.","family":"Mackinnon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie K.","family":"Cheok","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis J.","family":"Jareczek","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Neurosurgery","first-page":"6","article-title":"Guidelines for the management of severe traumatic brain injury, fourth edition","volume":"80","author":"Carney","year":"2017","unstructured":"Carney NTotten AMO\u2019Reilly CGuidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery. 2017;80(1):6-15. doi:10.1227\/NEU.0000000000001432"},{"issue":"3","key":"bib2","series-title":"Oper Neurosurg","first-page":"288","article-title":"Pseudoaneurysm of the superficial temporal artery after intracranial pressure monitoring device placement: case report of a rare complication","volume":"19","author":"Pan","year":"2020","unstructured":"Pan JBarros GGreil MEMeyer RMEne CIChesnut RM.Pseudoaneurysm of the superficial temporal artery after intracranial pressure monitoring device placement: case report of a rare complication. Oper Neurosurg. 2020;19(3):288-291. doi:10.1093\/ons\/opaa151"},{"issue":"1","key":"bib3","series-title":"J Neurointerv Surg","first-page":"e3","article-title":"Intracranial pseudoaneurysm after intracranial pressure monitor placement","volume":"8","author":"Shah","year":"2016","unstructured":"Shah KJJones AMArnold PMEbersole K.Intracranial pseudoaneurysm after intracranial pressure monitor placement. 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Front Neurol. 2020;11:582. doi:10.3389\/fneur.2020.00582"},{"issue":"10","key":"bib8","series-title":"J Neurosurg Case Lessons","first-page":"CASE24745","article-title":"Delayed presentation and rupture of an intracranial pseudoaneurysm following penetrating trauma: illustrative case","volume":"9","author":"Asad","year":"2025","unstructured":"Asad SBindra GSRobinow ZRiordan M.Delayed presentation and rupture of an intracranial pseudoaneurysm following penetrating trauma: illustrative case. J Neurosurg Case Lessons. 2025;9(10):CASE24745. doi:10.3171\/CASE24745"},{"key":"bib9","series-title":"Surg Neurol Int","first-page":"31","article-title":"Iatrogenic pseudoaneurysms associated with cerebrospinal fluid diversion procedures","volume":"10","author":"Chalil","year":"2019","unstructured":"Chalil AStaudt MDLownie SP.Iatrogenic pseudoaneurysms associated with cerebrospinal fluid diversion procedures. Surg Neurol Int. 2019;10:31. doi:10.4103\/sni.sni_388_18"},{"issue":"1","key":"bib10","series-title":"J Neuroimaging","first-page":"140","article-title":"Iatrogenic pseudoaneurysm of the middle meningeal artery after external ventricular drain placement","volume":"25","author":"Grandhi","year":"2015","unstructured":"Grandhi RZwagerman NTLee PJovin TOkonkwo DO.Iatrogenic pseudoaneurysm of the middle meningeal artery after external ventricular drain placement. J Neuroimaging. 2015;25(1):140-141. doi:10.1111\/jon.12080"},{"issue":"4","key":"bib11","series-title":"Neurochirurgie","first-page":"101680","article-title":"Iatrogenic pseudoaneurysm after surgery: stay away from the evil. Case report and review of the literature","volume":"71","author":"Mansourt","year":"2025","unstructured":"Mansourt AMay ATravaglini FDufour HGraillon TFarah K.Iatrogenic pseudoaneurysm after surgery: stay away from the evil. Case report and review of the literature. 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Case report and review of the literature","volume":"41","author":"Dario","year":"1997","unstructured":"Dario ADorizzi AScamoni CCerati MBalcone Grimaldi G.Iatrogenic intracranial aneurysm. Case report and review of the literature. J Neurosurg Sci. 1997;41(2):195-202."},{"issue":"3","key":"bib15","series-title":"J Emerg Med","first-page":"e245","article-title":"Iatrogenic pseudoaneurysm-associated cerebral hemorrhage: a rare complication of burr hole drainage\u2014a case report","volume":"67","author":"Maher","year":"2024","unstructured":"Maher PJHui CBrun FSingel S.Iatrogenic pseudoaneurysm-associated cerebral hemorrhage: a rare complication of burr hole drainage\u2014a case report. 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World Neurosurg. 2024;183:45-55. doi:10.1016\/j.wneu.2023.11.135"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/2\/article-CASE251022.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/2\/article-CASE251022.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/2\/article-CASE251022.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:16Z","timestamp":1784073616000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/2\/article-CASE251022.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":16,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/case251022","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]}}}