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Case report
Onyx embolization of an avulsed thalamoperforator following endoscopic colloid cyst and lamina terminalis fenestration
  1. Raymond D Turner,
  2. Imran Chaudry,
  3. Aquilla Turk,
  4. Alejandro Spiotta
  1. Departments of Neurosurgery and Radiology, Medical University of South Carolina, Charleston, South Carolina, USA
  1. Correspondence to Dr Raymond D Turner, Department of Neurosciences, Medical University of South Carolina, 2712 Canebreak Lane, Mount Pleasant, SC 29466, USA; turnerrd{at}musc.edu

Abstract

A patient presented with headaches and was found to have a colloid cyst in the third ventricle and ventriculomegaly. The patient underwent endoscopic colloid cyst resection and third ventriculostomy without incidence. Prior to emergence, a blown right pupil was acutely noted, and bright red blood emanated from the ventricular drain that was routinely placed in the endoscopy tract at the conclusion of the procedure. CTangiography demonstrated active extravasation from the pre-pontine cistern into the third ventricle and subarachnoid space. Emergency DSA confirmed active extravasation from an avulsed thalamoperforator arising from the proximal right P1 posterior cerebral artery, which was immediately embolized without incident.

  • Hemorrhage
  • Stroke

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