“MASSIVE BI-FRONTAL EXTRADURAL HEMORRHAGE FOLLOWING EXTERNAL VENTRICULAR DRAIN (EVD) PLACEMENT”-A CASE REPORT

Abstract

One of the most important lifesaving procedures performed regularly in neurosurgical intensive care units is the insertion of an External Ventricular Drain (EVD).Complications arising from EVDs include hemorrhage, misplacement, dislodgement, blockage, and infection. We present a case of massive bi-frontal extradural hemorrhage following external ventricular drain (EVD) placement. A 23 years old male, diagnosed with dorsally exophytic midbrain and pontine glioma presented with headache, repeated vomiting and became drowsy. Non-contrast CT scan of head showed brainstem tumor with hydrocephalus. An EVD was inserted through right frontal twist drill craniostomy. Patient improved only to deteriorate 2 hours later. Repeat NCCT head showed massive bifrontal extradural hemorrhage. Immediate bi-frontal craniotomy and surgical evacuation of extradural hemorrhage was done. Complications of EVD insertions are many therefore preferably EVD insertion should be carried out in operation theratre and multiple attempts should be avoided, also controlled drainage of csf should be done.