TY - JOUR
T1 - Iatrogenic Pseudoaneurysm-Associated Cerebral Hemorrhage
T2 - A Rare Complication of Burr Hole Drainage – A Case Report
AU - Maher, Patrick J.
AU - Hui, Channing
AU - Brun, Francisco
AU - Singel, Soren
N1 - Publisher Copyright:
© 2024 Elsevier Inc.
PY - 2024/9
Y1 - 2024/9
N2 - Background: Nontraumatic intracranial hemorrhage occurs most commonly due to hypertension and is treated nonoperatively. Iatrogenic pseudoaneurysm from prior neurosurgical therapy represents a rarely described etiology for intracranial hemorrhage that may require emergent surgical therapy. Case Report: An elderly female patient was brought to the emergency department with fatigue but no recent trauma. Subsequent computed tomography of the brain revealed a right-sided intraparenchymal hematoma. Her history included burr hole drainage of a subdural hematoma near the site, so additional imaging was performed and revealed an arteriovenous malformation, later discovered on operative findings to be a pseudoaneurysm, as the cause of the current bleeding episode. Why Should an Emergency Physician Be Aware of This? Awareness of prior neurosurgical treatment, even including minor procedures, in patients with apparent spontaneous intracranial bleeding should prompt angiographic evaluation for arteriovenous malformation. If found, these lesions are more likely to benefit from surgical treatment.
AB - Background: Nontraumatic intracranial hemorrhage occurs most commonly due to hypertension and is treated nonoperatively. Iatrogenic pseudoaneurysm from prior neurosurgical therapy represents a rarely described etiology for intracranial hemorrhage that may require emergent surgical therapy. Case Report: An elderly female patient was brought to the emergency department with fatigue but no recent trauma. Subsequent computed tomography of the brain revealed a right-sided intraparenchymal hematoma. Her history included burr hole drainage of a subdural hematoma near the site, so additional imaging was performed and revealed an arteriovenous malformation, later discovered on operative findings to be a pseudoaneurysm, as the cause of the current bleeding episode. Why Should an Emergency Physician Be Aware of This? Awareness of prior neurosurgical treatment, even including minor procedures, in patients with apparent spontaneous intracranial bleeding should prompt angiographic evaluation for arteriovenous malformation. If found, these lesions are more likely to benefit from surgical treatment.
KW - Arteriovenous malformation
KW - Complications
KW - Intraparenchymal hemorrhage
KW - Neurosurgery
KW - Pseudoaneurysm
UR - http://www.scopus.com/inward/record.url?scp=85199132062&partnerID=8YFLogxK
U2 - 10.1016/j.jemermed.2024.04.003
DO - 10.1016/j.jemermed.2024.04.003
M3 - Article
AN - SCOPUS:85199132062
SN - 0736-4679
VL - 67
SP - e245-e248
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 3
ER -