Right frontal external ventricular drain

Case contributed by Anson Chan
Diagnosis certain


4-day history of severe headaches with associated neck pain, vomiting and photophobia.

Patient Data

Age: 55 years
Gender: Female

Baseline CT head


There is acute intraventricular hemorrhage within the bilateral lateral, third and fourth ventricles. This results in hydrocephalus.

Postoperative CT head


There is an interval right frontal external ventricle drain with the tip lying in the right frontal horn at the foramen of Monro. There is an interval reduction in ventriculomegaly, with a reduction in the bifrontal diameter.

In the left temporal lobe, abutting the lateral ventricle is an area of abnormal heterogeneous density.

Case Discussion

This case demonstrates good placement of a right frontal external ventricular drain, with the tip lying at the foramen of Monro in a patient with intraventricular hemorrhage. This results in a significant interval reduction of ventriculomegaly.

The patient proceeded to a cerebral angiogram the day after surgery, confirming a left temporal periventricular arteriovenous malformation. The patient was referred to a Gamma Knife center for consideration of treatment.

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