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How I do it: brainwashing for purulent ventriculitis

  • How I Do it
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Abstract

Background

The management of ventriculitis remains controversial, with no single management strategy that can provide a good outcome. There are few articles describing the brainwashing technique, and most for neonatal intraventricular hemorrhage. This technical note is important because it describes a practical way to perform brainwashing in case of ventriculitis, and it is more feasible compared to endoscopic lavage in developing countries.

Method

We describe in a stepwise fashion the surgical technique of ventricular lavage.

Conclusion

Ventricular lavage is a neglected technique that can help to improve ventricular infection and hemorrhage prognosis.

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Author information

Authors and Affiliations

  1. Division of Neurosurgery, Department of Surgery and Anatomy, Clinics Hospital of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil

    Jean Eduardo de Sousa Carvalho Dezena, Christian Luiz Baptista Gerbelli, Tiago Kiyoshi Kitabayashi Braga & Matheus Fernando Manzolli Ballestero

  2. Division of Neurosurgery, Department of Medicine, Federal University of São Carlos, UFSCAR, Sao Carlos, Brazil

    Matheus Fernando Manzolli Ballestero

Authors
  1. Jean Eduardo de Sousa Carvalho Dezena
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  2. Christian Luiz Baptista Gerbelli
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  3. Tiago Kiyoshi Kitabayashi Braga
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  4. Matheus Fernando Manzolli Ballestero
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Corresponding author

Correspondence to Tiago Kiyoshi Kitabayashi Braga.

Ethics declarations

Informed consent

The written informed consent to the procedure was obtained from the mother.

Consent for publication

The mother gave his informed consent for the redaction and publication of the paper and the intraoperative video.

Conflict of interest

The authors declare no competing interests.

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Summary of 10 keys points

1. Brainwashing with 2 ventricular catheters is alternative in purulent ventriculitis and/or difficult-to-treat ventriculitis.

2. This brainwashing with ventricular catheters is more feasible compared to endoscopic lavage in developing countries.

3. In small ventricles, consider not using the technique.

4. The coagulogram exams must be normal to avoid intraventricular bleeding.

5. A ventricular catheter should be implanted on each side. The irrigation with 0.9% saline solution is made through one catheter with simultaneous CSF drainage through the other catheter.

6. From the CSF drainage side, connect an external ventricular drain (EVD) system at 10–15 cm H2O.

7. Use warm 0.9% saline to avoid hypothermia.

8. The CSF should be clear at the end of the procedure. We use approximately 5 L for this purpose.

9. Watch out for intraventricular hemorrhage (CSF is likely to become hemorrhagic during drainage).

10. It is reasonable to perform a postoperative computed tomography (CT) scan to exclude complications.

Supplementary Information

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Supplementary file1 (WMV 27262 KB)

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de Sousa Carvalho Dezena, J.E., Gerbelli, C.L.B., Braga, T.K.K. et al. How I do it: brainwashing for purulent ventriculitis. Acta Neurochir 165, 3267–3269 (2023). https://doi.org/10.1007/s00701-023-05607-5

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  • DOI: https://doi.org/10.1007/s00701-023-05607-5

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