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External ventricular drain migration into the cisterna magna: A case report
Mary Angeline Luz Ubias Hernandez1, Kevin Ivan Peñaverde Chan2, Kathleen Joy O Khu1
1Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines.
Surgical Neurology International
|June 6, 2024
Summary
A rare case of external ventricular drain (EVD) migration to the cisterna magna after correct initial placement in the frontal horn is reported. This highlights potential complications of EVD use in neurosurgery.
Area of Science:
- Neurosurgery
- Neurology
Background:
- External ventricular drain (EVD) insertion is a standard neurosurgical procedure for acute hydrocephalus.
- EVDs are crucial for managing cerebrospinal fluid pressure and administering intraventricular medications.
Observation:
- A 46-year-old male patient developed postoperative meningitis and hydrocephalus requiring EVD insertion.
- The patient exhibited restlessness and frequent head movements during treatment with the EVD.
- Improvised EVD system was used for both drainage and intraventricular antibiotic delivery.
Findings:
- Initial computed tomography scans confirmed correct EVD placement in the frontal horn.
- Subsequent scans revealed unexpected inward migration of the EVD catheter to the cisterna magna.
- This represents the first reported instance of EVD migration to the cisterna magna in medical literature.
Implications:
- Catheter migration is a rare but significant complication of EVD placement.
- Such migration can lead to neurological deficits and adverse patient outcomes.
- Preventive strategies are crucial to mitigate the risks associated with EVD catheter displacement.
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