Extraventricular Drainage and Hematoma Evacuation to Treat Hydrocephalus Following Lysis of MCA Embolism
Vincent Prinz, MD; Marcus Czabanka, MD
Charite Hospital Berlin

This is a clinical case of an elderly female patient who developed signs of hydrocephalus after receiving systemic thrombolysis for a middle cerebral artery (MCA) embolism, which was followed by intra-arterial thrombolysis a day before. The procedures were assessed as successful. Later on, despite the initial success, she was found exhibiting impaired consciousness. A follow-up head computed tomography (CT) revealed hemorrhaging of the cerebellum leading to the compression of the fourth ventricle and subsequent hydrocephalus.

A decision was made to place an external ventricular drain (EVD), followed by a suboccipital craniotomy and evacuation of the cerebellar hematoma. An EVD is a temporary catheter specifically designed to drain cerebrospinal fluid (CSF) and facilitate the monitoring of intracranial pressure (ICP). This video provides a detailed overview of the key steps involved in the EVD placement and hematoma evacuation, offering critical insights from skin incision to wound closure.