Endovascular management of ventricular catheter-induced anterior cerebral artery false aneurysm: Technical case report

OBJECTIVE AND IMPORTANCE: We describe the case of a 3.3-kg infant who developed an anterior cerebral artery pseudoaneurysm after ventricular catheter placement. The lesion was treated with endovascular vessel sacrifice. CLINICAL PRESENTATION: A 3.3-kg infant with a myelomeningocele underwent repair and ventricular catheter insertion for hydrocephalus. During shunt insertion, intracerebral arterial bleeding was encountered. Subsequent arteriography demonstrated an anterior cerebral artery pseudoaneurysm. TECHNIQUE: Via a transfemoral artery approach, the aneurysm and feeding vessel were catheterized with a microcatheter and wire. The aneurysm and vessel were then sacrificed with detachable platinum coils. CONCLUSION: Arterial injury is uncommon after ventricular catheter placement. When it does occur, however, an unstable pseudoaneurysm may form. Endovascular techniques can be used to remedy this problem, thus at times obviating the need for a standard craniotomy, which can be particularly difficult in a newborn.