Hernandez Mary Angeline Luz Ubias, Chan Kevin Ivan Peñaverde, Khu Kathleen Joy O
Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines.
Department of Neurosciences, Philippine General Hospital, Manila, Philippines.
Surg Neurol Int. 2024 May 24;15:172. doi: 10.25259/SNI_67_2024. eCollection 2024.
External ventricular drain (EVD) insertion is a common neurosurgical procedure used to treat acute hydrocephalus. In this report, we present a rare case of an EVD that was initially correctly placed within the frontal horn but subsequently migrated to the cisterna magna, the first to be reported in the literature.
A 46-year-old man with postoperative meningitis and hydrocephalus underwent EVD insertion using an improvised EVD system. The EVD was also used as a route for the administration of intraventricular antibiotics. The patient was restless and agitated during his treatment, causing him to move his head frequently. Serial computed tomography scans showed that the EVD was initially correctly placed within the frontal horn and then migrated to the cisterna magna.
Inward catheter migration is a rare complication of EVD insertion and is an important concern since it may cause neurologic deficits and potentially harmful sequelae. We have also highlighted measures that can be taken to prevent a similar event in the future.
外置脑室引流管（EVD）置入是治疗急性脑积水的常见神经外科手术。在本报告中，我们呈现了一例罕见病例，EVD最初正确置入额叶角，但随后迁移至枕大池，这是文献中首次报道的此类病例。
一名46岁患有术后脑膜炎和脑积水的男性患者使用简易EVD系统进行了EVD置入。EVD还用作脑室内抗生素给药的途径。患者在治疗期间烦躁不安，频繁移动头部。系列计算机断层扫描显示，EVD最初正确置入额叶角，随后迁移至枕大池。
导管向内迁移是EVD置入的罕见并发症，是一个重要问题，因为它可能导致神经功能缺损和潜在的有害后遗症。我们还强调了未来可采取的预防类似事件的措施。
