# Acute intracranial hemorrhage during the installation of the LICOX microdialysis system: A case report

## TL;DR

A 14-year-old boy developed acute brain bleeding after a neuromonitoring procedure, requiring surgery to stop the bleeding and manage the complication.

## Contribution

This case highlights a rare but serious complication of neuromonitoring catheter insertion and emphasizes preventive measures.

## Key findings

- Acute intracranial hemorrhage occurred during the installation of the LICOX microdialysis system.
- Surgical intervention was required to coagulate the injured vessel and manage elevated intracranial pressure.
- Proper clotting assessment and post-insertion imaging may reduce such complications.

## Abstract

Neuro-monitoring is widely employed for the evaluation of intubated patients in the intensive care unit with stroke, severe head trauma, subarachnoid hemorrhage and/or hepatic encephalopathy. The present study reports the case of a patient with acute intracranial hemorrhage following the insertion of neuromonitoring catheters, which required surgical management. The patient was a 14-year-old male who sustained a severe traumatic brain injury and underwent a right-sided hemicraniectomy. During the installation of the neuromonitoring catheters, an acute hemorrhage was noted with a rapidly elevating intracranial pressure. A craniotomy was performed to identify and coagulate the injured cortical vessel. As demonstrated herein, the thorough evaluation of the clotting profile of the patient, a meticulous surgical technique and obtaining a post-insertion computed tomography scan may minimize the risk of any neuromonitoring-associated hemorrhagic complications.