Iatrogenic Acute Intracranial Hematoma Following Drainage Catheter Removal: A Report of 2 Cases and Literature Review

Abstract

This paper describes 2 unique cases of catheter removal-induced intracranial hemorrhage (CRIH). Acute intracranial hematoma including extradural, subdural, and ventricular hemorrhage is a rare but dangerous complication during catheter removal. Its occurrence is usually iatrogenic. The clinical data of two patients of CRIH were retrospectively collected with a brief review of the phenomenon. A huge subdural hematoma was confirmed in the first case and severe ventricular hematoma in the second case immediately after removing intracranial drains. Emergent craniotomy identified the parietal branch of superficial temporal artery and choroid plexus as the separate source of bleeding. According to the literature review, only 4 cases in 2 reports were diagnosed with CRIH. CRIH should be borne in mind during the procedure of removing a catheter for drainage. The chance of CRIH may be lowered by vigilant manipulation in the processes of both catheter insertion and removal. Early detection and timely evacuation is essential for good recovery. The first case is another example of CRIH in subdural cavity. However, CRIH in ventricles may also occur as demonstrated in the second patient, which was never reported to our knowledge.