Diabetes insipidus-an extremely rare complication from replacement of an external ventricular drain

Khandkar Ali Kawsar, Masna Bin Inam, Colin Watts

Research output: Contribution to journalArticlepeer-review


Insertion of an external ventricular drain (EVD) is one of the most common and most important lifesaving procedures encountered in the neurologic intensive care unit, but often done by the junior members of the team. A good number of complications may follow the insertion of EVD. In the available literature, only one case was reported with the placement of EVD in suprasellar cistern. There is no report of insertion or replacement of an EVD in the sella. Diabetes insipidus (DI) is also an unheard of complication of EVD. Here, we report a case where a patient with subarachnoid haemorrhage (SAH) with acute hydrocephalus needed CSF diversion and had an EVD, during replacement of which through the same tract, the new EVD went into the sellar floor and she developed diabetes insipidus (DI) eventually. The catheter was pulled out and the DI settled. DI may occur as a consequence of SAH. The rationale behind reporting this case is to differentiate the cause of DI; as following insertion of EVD in a patient of SAH, the development of DI should raise the suspicion of misplaced EVD, should not be left as a consequence of SAH and appropriate imaging should be obtained. To prevent this happening, preoperative verification of CT, image-guided insertion, measurement of the length of the tubing and careful anchorage of EVD to surrounding tissue are necessary.

Original languageEnglish
Pages (from-to)1377-1380
Number of pages4
JournalActa Neurochirurgica
Issue number7
Early online date9 May 2019
Publication statusPublished - 1 Jul 2019


  • Diabetes insipidus
  • External ventricular drain

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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