Iatrogenic bradycardia-asystole as a complication of an intracranial Ommaya reservoir

Abstract

We report a case of a previously unreported complication of an intracranial Ommaya reservoir catheter causing par-oxysmal episodes of bradycardia-asystole and syncope as a result of migration of the catheter tip into the left temporal lobe. These episodes were captured on ambulatory electroencephalography as syncopal events, but with interictal left temporal epi-leptiform discharges. These events promptly resolved after repositioning the catheter. There was a recurrence of these events 1 yr later, associated with remigration of the catheter tip into the left temporal lobe, necessitating removal of the Ommaya reservoir, rendering the patient symptom free. This is the first reported case of an iatrogenic and possibly ictal bradycardia-asystole syn-drome and underpins the importance of considering migration of indwelling intracranial catheters into sensitive regions of the cortex as a possible cause of paroxysmal episodes.

Keywords

Intracranial catheter - iatrogenic - bradycardia-asystole