Abstract
OBJECTIVEFreehand insertion of external ventricular drains (EVDs) using anatomical landmarks is considered the primary method for placement, although alternative techniques have shown improved accuracy in positioning. The purpose of this study was to retrospectively evaluate which features of the baseline clinical history and preprocedural CT scan predict EVD positioning into suboptimal and unsatisfactory locations when using the freehand insertion technique.METHODSA retrospective chart review was performed evaluating 189 consecutive adult patients who received an EVD via freehand technique through an anterior burr hole between January 1, 2014, and December 31, 2015, at a Level 1 trauma facility in Edmonton, Alberta, Canada. The primary outcome measures included features associated with suboptimal positioning (Kakarla grade 1 vs Kakarla grades 2 and 3). The secondary outcome measures were features associated with unsatisfactory positioning (Kakarla grades 1 and 2 vs Kakarla grade 3).RESULTSFifty-one EVDs (27%) were suboptimally positioned. Fifteen (8%) EVDs were placed into eloquent cortex or nontarget CSF spaces. Admitting diagnosis, head height-to-width ratio in axial plane, and side of predominant pathology were found to be ...Continue Reading
References
Dec 1, 1985·Journal of Neurosurgery·J B Ghajar
May 4, 2000·Journal of Neurosurgery·S T O'LearyC I Shaffrey
Mar 17, 2001·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·P V TheodosopoulosM W McDermott
Nov 8, 2003·European Radiology·M KrötzM Reiser
Jul 5, 2007·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·M StrowitzkiW I Steudel
Jan 5, 2008·Journal of Neurosurgery·David R HuyetteMichael Y Oh
Jan 22, 2008·Surgical Neurology·Brent R O'NeillMichael Y Oh
Feb 5, 2008·Journal of Neurosurgery·S Scott Lollis, David W Roberts
Oct 17, 2008·Neurocritical Care·Andrea SaladinoGiuseppe Lanzino
Feb 14, 2009·Neurocritical Care·David W Roberts
Nov 26, 2009·Neurosurgery·Ahmed K TomaNeil D Kitchen
Apr 20, 2010·Journal of Neurosurgery·Caroline HayhurstConor L Mallucci
Jan 25, 2011·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kai Rui WanAndrew Danks
Mar 29, 2011·Neurologia Medico-chirurgica·Christoph M WoernleHelmut Bertalanffy
Sep 6, 2011·Acta neurochirurgica·Mohammad Ghazi AbdohPhilippe Decq
Jul 4, 2012·Journal of Neurosurgery. Pediatrics·Michael R LevittSamuel R Browd
Jan 22, 2013·Journal of Neurosurgery·Thomas J WilsonStephen E Sullivan
Jul 31, 2013·Journal of Neurosurgery·Visish M SrinivasanMichael Y Oh
Jul 31, 2013·Journal of Neurointerventional Surgery·David FiorellaHenry H Woo
Sep 5, 2013·World Neurosurgery·Scott B PhillipsSatish Krishnamurthy
Feb 26, 2014·Acta neurochirurgica·Oliver P GautschiP Bijlenga
Feb 11, 2015·Stereotactic and Functional Neurosurgery·Vaibhav PatilKirby G Vosburgh
Jul 4, 2015·Journal of Neurosurgery. Pediatrics·Nathaniel K CoulsonPierre D Mourad
Citations
Jan 7, 2021·Acta neurochirurgica·Masoud PishjooHumain Baharvahdat
Jul 2, 2021·Frontiers in Neuroscience·Giuseppe Emmanuele UmanaLidia Strigari
Aug 2, 2021·Neurosurgical Focus·Frederick Van GestelJohnny Duerinck