Accidental intracranial infusion of parenteral nutrition in a preterm neonate

Amir Ahmadian, Jotham Manwaring, Devon Truong, Jeane McCarthy, Luis F. Rodriguez, Carolyn M. Carey, Gerald F. Tuite

Research output: Contribution to journalArticlepeer-review


Vascular access in the neonate can be challenging, especially in preterm infants. When other access is not available, superficial scalp veins can be safely used for vascular access. However, rare and potentially catastrophic complications can occur due to unique features of the neonatal skull and soft-tissue anatomy. The authors report a rare complication of vascular access in a preterm infant, which led to the direct infusion of parenteral nutrition into the intracranial space. The child had an excellent outcome after open drainage and irrigation of bilateral intracranial spaces and the spinal thecal sac. Relevant anatomy is illustrated, and an outcome-based literature review is presented on this rarely reported condition. Surgical and conservative management strategies are discussed, along with clinical and radiographic follow-up. Drainage and irrigation is advocated in patients with mass effect, viscous effusions, or declining neurological examination findings.

Original languageEnglish (US)
Pages (from-to)458-462
Number of pages5
JournalJournal of Neurosurgery: Pediatrics
Issue number4
StatePublished - Oct 2015


  • Neonate
  • Parenteral nutrition
  • Preterm
  • Scalp venous access
  • Subdural infusion

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology


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