Ventriculostomy associated haemorrhage: A complication of anti-platelet therapy during coiling

Abstract A young man with Fisher grade IV subarachnoid haemorrhage (SAH) underwent aneurysm coiling following external ventriculostomy. Coiling was complicated by thrombus formation and parent vessel occlusion necessitating anti-platelet therapy. Several hours after anti-platelet therapy, catastroph...

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Bibliographic Details
Published in:British journal of neurosurgery 2014-12, Vol.28 (6), p.782-784
Main Authors: Sims-Williams, Hugh P., Weinberg, Daniel, Jadun, Changez K., Brydon, Howard L.
Format: Article
Language:English
Subjects:
Adult
Aneurysms
Blood platelets
Endovascular Procedures - adverse effects
Hematoma, Subdural - chemically induced
Hematoma, Subdural - etiology
Hemorrhage
Humans
Male
Medical treatment
Neurosurgery
Platelet Aggregation Inhibitors - adverse effects
Risk assessment
Subarachnoid Hemorrhage - drug therapy
Subarachnoid Hemorrhage - surgery
Ventriculostomy - adverse effects
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Summary:Abstract A young man with Fisher grade IV subarachnoid haemorrhage (SAH) underwent aneurysm coiling following external ventriculostomy. Coiling was complicated by thrombus formation and parent vessel occlusion necessitating anti-platelet therapy. Several hours after anti-platelet therapy, catastrophic haemorrhage associated with the ventriculostomy tract occurred. Timing and location of haemorrhage suggest combined anti-platelet therapy and ventriculostomy may have been causal. The literature on ventriculostomy haemorrhage rates and risks with concomitant anti-platelet therapy are reviewed. Where endovascular coiling is being considered, the possibility of ventriculostomy-related haemorrhage should be considered and should influence subsequent treatment decisions.
ISSN:0268-8697
1360-046X
DOI:10.3109/02688697.2014.915006