Large intracranial haemorrhage with malpositioned external ventricular drain

Case contributed by Dr Henry Knipe

Presentation

LOC.

Patient Data

Age: 50
Gender: Female

Left frontal EVD is noted with the tip within white matter (i.e. not intraventricular); linear haemorrhage in the left frontal lobe and left basal ganglia is new. Large right parenchymal haemorrhage centred on the right basal ganglia extending to involve the right thalamus results in midline shift to the left of 8 mm (previously 10 mm). Intraventricular haemorrhage is noted to the level of the fourth ventricle which results in mild obstructive hydrocephalus. There is some subarachnoid extension on the right through the sylvian fissure.

Case Discussion

The tip lies within white matter, not within the lateral ventricles. This means the drain is non-therapeutic and requires repositioning otherwise the obstructive hydrocephalus will worsen. 

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Case information

rID: 37059
Case created: 24th May 2015
Last edited: 10th Dec 2016
Tag: evd
Inclusion in quiz mode: Included

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