Pontine infarction caused by medial branch injury of the basilar artery as a rare complication of cisternal drain placement

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Horiuchi, Tetsuyoshi ; Yamamoto, Yasunaga ; Kuroiwa, Masafumi ; Rahmah, Nunung Nur ; Hongo, Kazuhiro (2012)
  • Publisher: ELSEVIER SCI LTD
  • Journal: JOURNAL OF CLINICAL NEUROSCIENCE, volume 19, issue 4, pages 592-593
  • Subject: Aneurysm | Complication | Subarachnoid hemorrhage | Infarction | Cisternal drain
    mesheuropmc: cardiovascular system | cardiovascular diseases

We present a rare complication of cisternal drain placement during aneurysm surgery. A ruptured anterior communicating artery aneurysm was clipped through a right pterional approach. A cisternal drain was inserted from the retro-carotid to the prepontine cistern. Postoperatively, a left-sided paresis of the upper extremity had developed. A CT brain scan revealed that the drain was located between the pons and the basilar artery, resulting in a pontine infarction. Vascular neurosurgeons should keep this complication in mind when placing a cisternal drain tube. The drain tube should not be inserted too deep into the prepontine cistern.
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