Complete basilar artery occlusion following ventriculoperitoneal shunt placement for giant aneurysm complicated by concurrent obstructive hydrocephalus: A case report
Objective: Giant aneurysms are infrequently complicated with obstructive hydrocephalus (HC), however, when concurrent, effective treatments are unestablished. There are incredibly few reports of HC due to basilar artery giant aneurysms and fewer reports regarding ventriculoperitoneal (VP) shunt comp...
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| Format: | Article |
| Language: | English |
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KeAi Communications Co., Ltd.
2023-06-01
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| Series: | Brain Hemorrhages |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589238X22000572 |
| _version_ | 1797812769107476480 |
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| author | Molly Monsour Elliot Neal Davide Marco Croci Maxim Mokin Waldo Guerrero Kunal Vakharia Siviero Agazzi Harry Van Loveren |
| author_facet | Molly Monsour Elliot Neal Davide Marco Croci Maxim Mokin Waldo Guerrero Kunal Vakharia Siviero Agazzi Harry Van Loveren |
| author_sort | Molly Monsour |
| collection | DOAJ |
| description | Objective: Giant aneurysms are infrequently complicated with obstructive hydrocephalus (HC), however, when concurrent, effective treatments are unestablished. There are incredibly few reports of HC due to basilar artery giant aneurysms and fewer reports regarding ventriculoperitoneal (VP) shunt complications in these patients. Case presentation: We report the case of a gentleman in his 70 s who presented with a fusiform aneurysm of the entire basilar artery and mild intra-aneurysmal thrombosis. HC, secondary to the aneurysm, indicated VP shunt placement. Within 12 h following shunt placement, however, the patient deteriorated rapidly due to complete basilar artery occlusion and widespread brainstem ischemia. Endovascular intervention was unsuccessful due to extremely high clot burden. He unfortunately expired 2 days afterwards. Conclusion: Hydrocephalus due to aneurysms is not uncommon, and VP shunt placement should be optimized to avoid unforeseen complications like the one described. We suspect that the shunt placement aggravated the already aberrant flow within the aneurysm, propagating a pro-thrombotic environment. With further reports of this complication, a standardized method to place VP shunts for patients with giant aneurysms while minimizing the risk of thrombotic occlusion could be established. |
| first_indexed | 2024-03-13T07:42:23Z |
| format | Article |
| id | doaj.art-032795de15df4fb09d8e5e5b438f2ced |
| institution | Directory Open Access Journal |
| issn | 2589-238X |
| language | English |
| last_indexed | 2024-03-13T07:42:23Z |
| publishDate | 2023-06-01 |
| publisher | KeAi Communications Co., Ltd. |
| record_format | Article |
| series | Brain Hemorrhages |
| spelling | doaj.art-032795de15df4fb09d8e5e5b438f2ced2023-06-03T04:22:33ZengKeAi Communications Co., Ltd.Brain Hemorrhages2589-238X2023-06-01427276Complete basilar artery occlusion following ventriculoperitoneal shunt placement for giant aneurysm complicated by concurrent obstructive hydrocephalus: A case reportMolly Monsour0Elliot Neal1Davide Marco Croci2Maxim Mokin3Waldo Guerrero4Kunal Vakharia5Siviero Agazzi6Harry Van Loveren7University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, FL 33612, USADepartment of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USADepartment of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USA; Corresponding author at: Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USADepartment of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USADepartment of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USADepartment of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USADepartment of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USAObjective: Giant aneurysms are infrequently complicated with obstructive hydrocephalus (HC), however, when concurrent, effective treatments are unestablished. There are incredibly few reports of HC due to basilar artery giant aneurysms and fewer reports regarding ventriculoperitoneal (VP) shunt complications in these patients. Case presentation: We report the case of a gentleman in his 70 s who presented with a fusiform aneurysm of the entire basilar artery and mild intra-aneurysmal thrombosis. HC, secondary to the aneurysm, indicated VP shunt placement. Within 12 h following shunt placement, however, the patient deteriorated rapidly due to complete basilar artery occlusion and widespread brainstem ischemia. Endovascular intervention was unsuccessful due to extremely high clot burden. He unfortunately expired 2 days afterwards. Conclusion: Hydrocephalus due to aneurysms is not uncommon, and VP shunt placement should be optimized to avoid unforeseen complications like the one described. We suspect that the shunt placement aggravated the already aberrant flow within the aneurysm, propagating a pro-thrombotic environment. With further reports of this complication, a standardized method to place VP shunts for patients with giant aneurysms while minimizing the risk of thrombotic occlusion could be established.http://www.sciencedirect.com/science/article/pii/S2589238X22000572AneurysmVentriculoperitoneal shuntBasilar artery occlusionHydrocephalusGiant aneurysmThrombosis |
| spellingShingle | Molly Monsour Elliot Neal Davide Marco Croci Maxim Mokin Waldo Guerrero Kunal Vakharia Siviero Agazzi Harry Van Loveren Complete basilar artery occlusion following ventriculoperitoneal shunt placement for giant aneurysm complicated by concurrent obstructive hydrocephalus: A case report Brain Hemorrhages Aneurysm Ventriculoperitoneal shunt Basilar artery occlusion Hydrocephalus Giant aneurysm Thrombosis |
| title | Complete basilar artery occlusion following ventriculoperitoneal shunt placement for giant aneurysm complicated by concurrent obstructive hydrocephalus: A case report |
| title_full | Complete basilar artery occlusion following ventriculoperitoneal shunt placement for giant aneurysm complicated by concurrent obstructive hydrocephalus: A case report |
| title_fullStr | Complete basilar artery occlusion following ventriculoperitoneal shunt placement for giant aneurysm complicated by concurrent obstructive hydrocephalus: A case report |
| title_full_unstemmed | Complete basilar artery occlusion following ventriculoperitoneal shunt placement for giant aneurysm complicated by concurrent obstructive hydrocephalus: A case report |
| title_short | Complete basilar artery occlusion following ventriculoperitoneal shunt placement for giant aneurysm complicated by concurrent obstructive hydrocephalus: A case report |
| title_sort | complete basilar artery occlusion following ventriculoperitoneal shunt placement for giant aneurysm complicated by concurrent obstructive hydrocephalus a case report |
| topic | Aneurysm Ventriculoperitoneal shunt Basilar artery occlusion Hydrocephalus Giant aneurysm Thrombosis |
| url | http://www.sciencedirect.com/science/article/pii/S2589238X22000572 |
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