EARLY TREATMENT OF POST-HEMORRHAGIC VENTRICULAR DILATATION OF THE NEWBORN WITH LONG-TERM EXTERNAL VENTRICULAR DRAINAGE.

1994 ◽  
Vol 22 (s1) ◽  
pp. 185-186
Author(s):  
M.L. Massone ◽  
A. Cama ◽  
V.F. Puccio ◽  
G. Montobbio ◽  
M. Soliani ◽  
...  
Keyword(s):  
Early Treatment ◽  
External Ventricular Drainage ◽  
Ventricular Dilatation ◽  
Ventricular Drainage

scholarly journals SURG-02. INITIAL MANAGEMENT OF HYDROCEPHALUS IN THE PEDIATRIC AND YOUNG-ADULT PATIENTS WITH BRAIN TUMORS; THE EFFICACY OF LONG-TERM INDWELLING EXTERNAL VENTRICULAR DRAINAGE

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii461-iii461
Author(s):  
Shigeru Yamaguchi ◽  
Hiroaki Motegi ◽  
Yukitomo Ishi ◽  
Michinari Okamoto ◽  
Akihiro Iguchi ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Young Adult ◽  
Brain Tumors ◽  
External Ventricular Drainage ◽  
The Body ◽  
Ventricular Drainage ◽  
Initial Management ◽  
Effective Option ◽  
Csf Diversion

Abstract BACKGROUND Pediatric and Young-Adult (AYA) brain tumors often present with hydrocephalus. As temporary cerebrospinal fluid (CSF) diversion procedure, we perform long-term indwelling external ventricular drainage (EVD) in the case of the management of CSF diversion more than two weeks presumably. The aim of this study is to investigate the initial management for hydrocephalus in pediatric /AYA patients with brain tumor, especially about long-term EVD. MATERIALS AND METHODS The patients less than 30 years of age diagnosed with brain tumor between 2005 and 2019 were retrospectively analyzed. Procedures of long-term EVD were similar to that of ventriculoperitoneal shunt (VPS) operation. Using flow-control VPS system, peritoneal catheter passed out of the body at the anterior chest, and distal end of the catheter was connected to standard EVD system. RESULTS In total of 345 patients with brain tumor, 109 had hydrocephalus at presentation. Among them, 25 patients (23%) underwent long-term EVD. The main reasons for selecting long-term EVD were to avoid intraperitoneal dissemination (n=13), and to maintain longer period of CSF diversion for the treatment of tumor (n=12). The median of long-term EVD was 38 days (range: 12 – 222 days). Although one case suffered from drainage tube occlusion at 59 days, there were no other complications such as infection or accidental evulsion. Eventually, 3 cases required permanent VPS for persistent hydrocephalus. CONCLUSION Long-term EVD is safe and effective option for CSF diversion. This procedure should be taken into consideration if patients have a risk of dissemination and may elude permanent VPS.

Shunt surgery for hydrocephalus in tuberculous meningitis: a long-term follow-up study

1991 ◽  
Vol 74 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Ravi Palur ◽  
Vedantam Rajshekhar ◽  
Mathew J. Chandy ◽  
Thomas Joseph ◽  
Jacob Abraham
Keyword(s):  
Tuberculous Meningitis ◽  
External Ventricular Drainage ◽  
Shunt Surgery ◽  
Ventricular Drainage ◽  
Initial Examination ◽  
Long Term Outcome ◽  
Long Term Follow Up ◽  
Grade Iii

✓ Hydrocephalus is a common complication of tuberculous meningitis. Case studies of 114 patients with tuberculous meningitis and hydrocephalus, who underwent shunt surgery between July, 1975, and June, 1986, were reviewed to evaluate the long-term outcome and to outline a management protocol for these patients based on the results. Seven factors were studied in each case: 1) age at admission; 2) grade on admission (I to IV, classified by the authors: Grade I being the best and Grade IV being the worst); 3) duration of alteration of sensorium; 4) cerebrospinal fluid (CSF) cell content at initial examination; 5) CSF protein levels at initial examination; 6) number of shunt revisions required; and 7) the necessity for bilateral shunts. During a long-term follow-up period ranging from 6 months to 13 years (mean 45.6 months), the mortality rate was 20% for patients in Grade I; 34.7% for patients in Grade II; 51.9% for patients in Grade III; and 100% for patients in Grade IV. Only the grade at the time of admission was found to be statistically significant in determining final outcome (p < 0.001). Based on these results, the authors advocate early shunt surgery for Grade I and II patients. For patients in Grade III, surgery may be performed either if external ventricular drainage causes an improvement in sensorium or without selection. All patients in Grade IV should undergo external ventricular drainage and only those who show a significant change in their neurological status within 24 to 48 hours of drainage, should have shunt surgery.

Long-term experience with subcutaneously tunneled external ventricular drainage in preterm infants

2000 ◽  
Vol 16 (2) ◽  
pp. 103-109 ◽  
Author(s):  
A. Berger ◽  
M. Weninger ◽  
A. Reinprecht ◽  
N. Haschke ◽  
C. Kohlhauser ◽  
...  
Keyword(s):  
Preterm Infants ◽  
External Ventricular Drainage ◽  
Ventricular Drainage ◽  
Long Term Experience

scholarly journals External ventricular drainage for posthemorrhagic ventricular dilatation in preterm infants: insights on efficacy and failure

2021 ◽  
pp. 1-9
Author(s):  
Laura C. De Angelis ◽  
Alessandro Parodi ◽  
Marianna Sebastiani ◽  
Alessandro Consales ◽  
Giuseppe M Ravegnani ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Free Group ◽  
Gestational Age ◽  
External Ventricular Drain ◽  
External Ventricular Drainage ◽  
Ventricular Dilatation ◽  
Ventricular Drainage ◽  
Posthemorrhagic Hydrocephalus ◽  
The Mean

OBJECTIVE The objective of this study was to describe the clinical and neuroradiological characteristics of a cohort of preterm infants who had undergone external ventricular drain insertion as a temporary measure to treat posthemorrhagic ventricular dilatation. In addition, the authors investigated the factors predicting permanent shunt dependency. METHODS The authors retrospectively reviewed the medical records of a cohort of preterm infants who had undergone external ventricular drain insertion at Gaslini Children’s Hospital (Genoa, Italy) between March 2012 and February 2018. They also analyzed clinical characteristics and magnetic resonance imaging data, including diffusion- and susceptibility-weighted imaging studies, which were obtained before both catheter insertion and removal. RESULTS Twenty-eight infants were included in the study. The mean gestational age was 28.2 ± 2.7 weeks, and the mean birth weight was 1209 ± 476 g. A permanent ventriculoperitoneal shunt was inserted in 15/28 (53.6%) infants because of the failure of external ventricular drainage as a temporary treatment option. Compared with the shunt-free group, the shunt-dependent group had a significantly lower gestational age (29.3 ± 2.3 vs 27.2 ± 2.7 weeks, p = 0.035) and tended toward a lower birth weight (p = 0.056). None of the clinical and neuroradiological characteristics significantly differed between the shunt-free and shunt-dependent groups at the time of catheter insertion. As expected, ventricular parameters as well as the intraventricular extension of intracerebral hemorrhage, as assessed using the intraventricular hemorrhage score, were reportedly higher in the shunt-dependent group than in the shunt-free group before catheter removal. CONCLUSIONS External ventricular drainage is a reliable first-line treatment for posthemorrhagic hydrocephalus. However, predicting its efficacy as a unique treatment remains challenging. A lower gestational age is associated with a higher risk of posthemorrhagic hydrocephalus progression, suggesting that the more undeveloped the mechanisms for the clearance of blood degradation products, the greater the risk of requiring permanent cerebrospinal fluid diversion, although sophisticated MRI investigations are currently unable to corroborate this hypothesis.

Broviac Ventriculostomy for Long-Term External Ventricular Drainage

1991 ◽  
Vol 17 (4) ◽  
pp. 208-212 ◽  
Author(s):  
Michael J. Chaparro ◽  
Michael B. Pritz ◽  
Kenneth S. Yonemura
Keyword(s):  
External Ventricular Drainage ◽  
Ventricular Drainage

Catheter fixation and ligation: a simple technique for ventriculostomy management following endovascular stenting

2013 ◽  
Vol 118 (5) ◽  
pp. 1009-1013 ◽  
Author(s):  
Justin M. Sweeney ◽  
Rohit Vasan ◽  
Harry R. van Loveren ◽  
A. Samy Youssef ◽  
Siviero Agazzi
Keyword(s):  
Antithrombotic Therapy ◽  
External Ventricular Drainage ◽  
Ventricular Drainage ◽  
Management Options ◽  
Shunt System ◽  
Long Term Follow Up ◽  
Unique Method ◽  
Risk Of Hemorrhage

The object of this study was to describe a unique method of managing ventriculostomy catheters in patients on antithrombotic therapy following endovascular treatment of ruptured intracranial aneurysms. The authors retrospectively reviewed 3 cases in which a unique method of ventriculostomy management was used to successfully avoid catheter-related hemorrhage while the patient was on dual antiplatelet therapy. In this setting, ventriculostomy catheters are left in place and fixed to the calvarium with titanium straps effectively ligating them. The catheter is divided and the distal end is removed. The proximal end can be directly connected to a distal shunt system during this stage or at a later date if necessary. The method described in this report provided a variety of management options for patients requiring external ventricular drainage for subarachnoid hemorrhage. No patient suffered catheter-related hemorrhage. This preliminary report demonstrates a safe and effective method for discontinuing external ventricular drainage and/or placing a ventriculoperitoneal shunt in the setting of active coagulopathy or antithrombotic therapy. The technique avoids both the risk of hemorrhage related to catheter removal and reinsertion and the thromboembolic risks associated with the reversal of antithrombotic therapy. Some aneurysm centers have avoided the use of stent-assisted coiling in cases of ruptured aneurysms to circumvent ventriculostomy-related complications; however, the method described herein should allow continued use of this important treatment option in ruptured aneurysm cases. Further investigation in a larger cohort with long-term follow-up is necessary to define the associated risks of infection using this method.

Prolonged external ventricular drainage with percutaneous long-tunnel ventriculostomies

1995 ◽  
Vol 83 (5) ◽  
pp. 791-794 ◽  
Author(s):  
Rohit K. Khanna ◽  
Mark L. Rosenblum ◽  
Jack P. Rock ◽  
Ghaus M. Malik
Keyword(s):  
Prophylactic Antibiotic ◽  
External Ventricular Drainage ◽  
Ventricular Catheter ◽  
Ventricular Drainage ◽  
Risk Of Infection ◽  
Content Type ◽  
Gram Staining ◽  
Short Tunnel ◽  
Upper Abdomen

✓ External ventricular drainage has been used extensively for management of several neurosurgical disorders. The main limitation of this procedure has been the high risk of infection, especially with prolonged drainage. In an effort to minimize the risk of infection, the authors have used a new ventriculostomy technique that involves tunneling the ventricular catheter subcutaneously to an exit site in the lower chest or upper abdomen. This report describes the results of this procedure on 100 consecutive cases. Patients requiring emergency ventriculostomies had short-tunnel ventriculostomies placed at the bedside that were converted to long-tunnel ventriculostomies in the operating room within 5 days. The average duration of drainage was 18.3 days (range 5–40 days). Cerebrospinal fluid was routinely sent for Gram staining and culture to monitor for infection. Prophylactic antibiotic medications were administered only perioperatively. No infection was observed during the first 16 days of drainage in any patient. The overall incidence of infection was 4% and blockage occurred in 6% of the cases. In this series the incidence of ventricular infection was 2.37 per 1000 ventricular drainage days, one of the lowest reported incidences of infection in the literature. This procedure provides a simple and effective method of maintaining long-term ventricular drainage with a very low risk of infection or blockage.

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