Image guidance and improved accuracy of external ventricular drain tip position particularly in patients with small ventricles

Journal of Neurosurgery
Anan ShtayaDiederik Bulters

Abstract

OBJECTIVEExternal ventricular drain (EVD) insertion is one of the most common emergency neurosurgical procedures. EVDs are traditionally inserted freehand (FH) in an emergency setting, but often result in suboptimal positioning. Image-guided surgery (IGS) is selectively used to assist placement. However, the accuracy and practicality of IGS use is yet to be reported. In this study, the authors set out to assess if IGS is practical and improves the accuracy of EVD placement.METHODSCase notes and images obtained in patients who underwent frontal EVD placement were retrospectively reviewed. Ventriculomegaly was determined by the measurement of the Evans index. EVD location was classified as optimal (ipsilateral frontal horn) or suboptimal (any other location). Propensity score matching of the two groups (IGS vs FH) for the Evans index was performed. Data were analyzed for patient age, diagnosis, number of EVDs, and complications. Those without postoperative CT scans were excluded.RESULTSA total of 607 patients with 760 EVDs placed were identified; 331 met inclusion criteria. Of these, 287 were inserted FH, and 44 were placed with IGS; 60.6% of all unmatched FH EVDs were optimal compared with 75% of the IGS group (p = 0.067). The I...Continue Reading

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Citations

Feb 6, 2020·Frontiers in Neurology·Sarah Hornshøj PedersenMarianne Juhler
Jan 7, 2021·Acta neurochirurgica·Masoud PishjooHumain Baharvahdat
Dec 18, 2020·International Journal of Computer Assisted Radiology and Surgery·Zongchao YiWenyao Hong
Jul 2, 2021·Frontiers in Neuroscience·Giuseppe Emmanuele UmanaLidia Strigari
Jan 30, 2021·Journal of Neurosurgery·Aaron Lawson McLeanUNKNOWN British Neurosurgical Trainee Research Collaborative

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