scholarly journals Neuronavigation device for stereotaxic external ventricular drainage insertion

2021 ◽  
Vol 12 ◽  
pp. 266
Author(s):  
Anton Konovalov ◽  
Dmitry Okishev ◽  
Oleg Shekhtman ◽  
Yuri Pilipenko ◽  
Shalva Eliava
Keyword(s):  
External Ventricular Drainage ◽  
Early Postoperative Period ◽  
Neurosurgical Procedures ◽  
Ventricular Drainage ◽  
Catheter Position ◽  
Posthemorrhagic Hydrocephalus ◽  
Cerebrospinal Fluid Circulation ◽  
Oncological Diseases ◽  
Tomography Data ◽  
Impaired Circulation

Background: The insertion of an external ventricular drainage (EVD) is one of the most frequently used neurosurgical procedures. It is performed to adjust intracranial hypertension in cases of severe craniocerebral injury, acute posthemorrhagic hydrocephalus, meningitis, and oncological diseases related to impaired circulation of cerebrospinal fluid circulation (CSF). Methods: In 2020, three patients with subarachnoid aneurysmal hemorrhage underwent insertion of an EVD navigation percutaneous stereotaxic device. Three cases introduced. Results: In all cases, satisfactory EVD functioning was noted during the surgery and during the early postoperative period. The EVD insertion procedure took an average of 10 min. The EVD insertion route calculations using the software took about 5–15 min. No cases showed any infection, hemorrhagic complications, or EVD dysfunction. According to the control brain computed tomography data, the catheter position was satisfactory and corresponded to the target coordinates in all cases. Conclusion: The use of the device, with its high accuracy and efficiency, can reduce the incidence of unsatisfactory EVD implantation cases in patients with neurosurgical pathology.

External Ventricular Drainage for Treatment of Rapidly Progressive Posthemorrhagic Hydrocephalus

Neurosurgery ◽  
1992 ◽  
Vol 31 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Manfred Weninger ◽  
Hans Robert Salzer ◽  
Arnold Pollak ◽  
Martina Rosenkranz ◽  
Peter Vorkapic ◽  
...  
Keyword(s):  
External Ventricular Drainage ◽  
Ventricular Drainage ◽  
Posthemorrhagic Hydrocephalus

The history of external ventricular drainage

2014 ◽  
Vol 120 (1) ◽  
pp. 228-236 ◽  
Author(s):  
Visish M. Srinivasan ◽  
Brent R. O'Neill ◽  
Diana Jho ◽  
Donald M. Whiting ◽  
Michael Y. Oh
Keyword(s):  
Traumatic Brain Injury ◽  
Virtual Reality ◽  
18Th Century ◽  
External Ventricular Drainage ◽  
Neurosurgical Procedures ◽  
Reye Syndrome ◽  
Ventricular Drainage ◽  
Icp Monitoring ◽  
History Of ◽  
Materials Used

External ventricular drainage (EVD) is one of the most commonly performed neurosurgical procedures. It was first performed as early as 1744 by Claude-Nicholas Le Cat. Since then, there have been numerous changes in technique, materials used, indications for the procedure, and safety. The history of EVD is best appreciated in 4 eras of progress: development of the technique (1850–1908), technological advancements (1927–1950), expansion of indications (1960–1995), and accuracy, training, and infection control (1995–present). While EVD was first attempted in the 18th century, it was not until 1890 that the first thorough report of EVD technique and outcomes was published by William Williams Keen. He was followed by H. Tillmanns, who described the technique that would be used for many years. Following this, many improvements were made to the EVD apparatus itself, including the addition of manometry by Adson and Lillie in 1927, and continued experimentation in cannulation/drainage materials. Technological advancements allowed a great expansion of indications for EVD, sparked by Nils Lundberg, who published a thorough analysis of the use of intracranial pressure (ICP) monitoring in patients with brain tumors in 1960. This led to the application of EVD and ICP monitoring in subarachnoid hemorrhage, Reye syndrome, and traumatic brain injury. Recent research in EVD has focused on improving the overall safety of the procedure, which has included the development of guidance-based systems, virtual reality simulators for trainees, and antibiotic-impregnated catheters.

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.

External Ventricular Drainage for Treatment of Rapidly Progressive Posthemorrhagic Hydrocephalus

Neurosurgery ◽  
1992 ◽  
Vol 31 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Manfred Weninger ◽  
Hans Robert Salzer ◽  
Arnold Pollak ◽  
Martina Rosenkranz ◽  
Peter Vorkapic ◽  
...  
Keyword(s):  
External Ventricular Drainage ◽  
Ventricular Drainage ◽  
Posthemorrhagic Hydrocephalus

External ventricular drainage for control of posthemorrhagic hydrocephalus in premature infants

1981 ◽  
Vol 55 (5) ◽  
pp. 766-770 ◽  
Author(s):  
Robert E. Harbaugh ◽  
Richard L. Saunders ◽  
William H. Edwards
Keyword(s):  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
External Ventricular Drainage ◽  
Ventricular Drainage ◽  
Medical Problems ◽  
Posthemorrhagic Hydrocephalus ◽  
Content Type ◽  
The Mean ◽  
Tunneled Catheter ◽  
Initial Method

✓ Over a 3-year period, 11 premature infants with intraventricular hemorrhage and posthemorrhagic hydrocephalus were managed initially with prolonged external ventricular drainage via a subcutaneously tunneled catheter. The mean duration of drainage for this group was 20.7 days. Although two patients died before shunting was considered, no morbidity or mortality was observed to result from this technique. Seven patients required a shunt after stabilization of their medical problems. Two patients, followed for 24 and 40 months, have not required shunting procedures. External ventricular drainage via a subcutaneously tunneled catheter has been found to be a safe and reliable initial method of treating posthemorrhagic hydrocephalus in premature infants.

External Ventricular Drainage for Initial Treatment of Neonatal Posthemorrhagic Hydrocephalus: Surgical and Neurodevelopmental Outcome

1987 ◽  
Vol 13 (5) ◽  
pp. 255-262 ◽  
Author(s):  
Torunn T. Rhodes ◽  
William H. Edwards ◽  
Richard L. Saunders ◽  
Robert E. Harbaugh ◽  
Carol L.C. Little ◽  
...  
Keyword(s):  
Initial Treatment ◽  
Neurodevelopmental Outcome ◽  
External Ventricular Drainage ◽  
Ventricular Drainage ◽  
Posthemorrhagic Hydrocephalus

Gradual External Ventricular Drainage Weaning Reduces The Risk of Shunt Dependency After Aneurysmal Subarachnoid Hemorrhage: A Pooled Analysis

2018 ◽  
Vol 15 (5) ◽  
pp. 498-504 ◽  
Author(s):  
Ramazan Jabbarli ◽  
Daniela Pierscianek ◽  
Roland RÖlz ◽  
Matthias Reinhard ◽  
Marvin Darkwah Oppong ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
External Ventricular Drainage ◽  
Pooled Analysis ◽  
Ventricular Drainage ◽  
University Hospitals ◽  
Posthemorrhagic Hydrocephalus ◽  
Shunt Placement ◽  
Shunt Dependency ◽  
Independent Association

Abstract BACKGROUND Chronic posthemorrhagic hydrocephalus necessitating shunt placement is a common complication of subarachnoid hemorrhage (SAH). OBJECTIVE To evaluate the role of external ventricular drainage (EVD) weaning on risk of shunt dependency after SAH. METHODS Two German university hospitals with different EVD management regimes (rapid weaning [RW] vs gradual weaning [GW]) pooled the data of their observational cohorts containing altogether 1171 consecutive SAH patients treated between January 2005 and December 2012. Development and timing of shunt dependency in SAH survivals were the endpoints of the study. RESULTS The final cohort consisted of 455 and 510 SAH survivors treated in the centers with RW and GW, respectively. Mortality rates, as well as baseline demographic, clinical, and radiographic parameters, showed no differences between the centers. Patients with GW were less likely to develop shunt dependency (27.5% vs 34.7%, P = .018), Multivariate analysis confirmed independent association between RW regime and shunt dependency (P = .026). Shunt-dependent SAH patients undergoing GW required significantly longer time until shunting (mean 29.8 vs 21.7 d, P < .001) and hospital stay (mean 39 vs 34.4 d, P = .03). In addition, patients with GW were at higher risk for secondary shunt placement after successful initial weaning (P = .001). The risk of cerebrospinal fluid infection was not associated with the weaning regime (15.3% vs 12.9%, P = .307). CONCLUSION At the expense of longer treatment, GW may decrease the risk of shunt dependency after SAH without an additional risk for infections. Due to the risk of secondary shunt dependency, SAH patients with GW require proper posthospital neurological care.

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