What is external ventriculostomy?

Abstract. External ventricular drainage systems (EVDs), or external ventriculostomies, are challenging additions for the neurosurgical patient. An EVD involves a catheter placed in the ventricular space. It is used to drain off excess cerebrospinal fluid that is causing hydrocephalus and increased intracranial pressure …

Where do you level a ventriculostomy?

The laser level device should be in line with the patient’s Foramen of Monro (FOM). If the patient is supine with their head neutral, level the EVD system to the tragus of the ear. If the patient is lateral, level the EVD to the mid sagittal line (between the eyebrows).

How does a ventriculostomy work?

A ventriculostomy allows diversion of CSF normally contained within the ventricular system, thereby decompressing the spaces and facilitating normalization of ICP. In this procedure, a pliable silastic catheter is passed with a rigid internal stylet through the brain parenchyma to the ventricle.

How is an EVD inserted?

A surgeon inserts the EVD during surgery. Once your child receives medicine to help them sleep, a healthcare provider will shave a small area of their head. The surgeon makes an opening in the shaved skin and then makes a small opening in the skull to insert the tube into a ventricle (fluid-filled area).

When is Ventriculostomy used?

In addition to its primary use as an ICP monitor, a ventriculostomy is commonly used in the ICU as a drain for patients with TBI or hydrocephalus. Common causes of acute hydrocephalus in an adult ICU include cerebellar stroke or hemorrhage, intraventricular hemorrhage, and aneurysmal subarachnoid hemorrhage.

What is external drainage system?

External ventricular drainage (EVD) is a temporary method of draining cerebrospinal fluid (CSF) from the ventricles in the brain. The external ventricular drainage (EVD) system uses a catheter (a thin, plastic tube), which is placed in the ventricle of the brain. This is connected to a drainage system outside the body.

Is Ventriculostomy permanent?

Ventriculostomy or ventricular drain is a quick surgical procedure performed in the head to attach a device to drain cerebrospinal fluid (CSF) buildup in the brain. This device may be placed externally, and it can be either temporary or permanent.

Is ventriculostomy permanent?

When is ventriculostomy used?

When should EVD be removed?

If the patient tolerates closure of the EVD without recurrent symptoms of hydrocephalus or radiographic evidence of enlarging ventricles, the drain is removed; if it is not, the hydrocephalus usually requires more definitive treatment.

How much should an EVD drain per hour?

Drainage should not be turned off for longer than needed, as this can cause the catheter to block. Early signs of over-drainage include headaches, and the neurosurgical team should be notified urgently if the rate of drainage exceeds 10ml per hour or a total of more than 30ml drains in one hour (Woodward et al, 2002).

What is the purpose of Ventriculostomy?