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Accuracy of external ventricular drainage catheter placement

  • Clinical Article
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Abstract

Background

External ventricular drainage (EVD) is a freehand neurosurgical procedure performed routinely using the anatomical landmarks.

Objective

The aim of this study was to determine the accuracy of EVD catheter freehand placement.

Materials and methods

Pre-operative and post-operative computed tomography scans for 66 consecutive EVDs performed in 56 adult patients (26 men, 30 women) in 2008 were retrospectively reviewed. Etiologies of acute hydrocephalus were subarachnoid or intraventricular haemorrhage (43 cases) or miscellaneous (13 cases). Pre-operative lateral ventricular volume, position of the burr hole, length of the catheter and its sagittal and coronal angular variations from a theoretical trajectory were measured.

Results

The EVD was placed on the right (53 cases) or left (13 cases) side. The mean pre-operative lateral ventricular volume was 51 cc (10–118 cc). The average distance from the burr hole to the midline was 28 mm (10–49 mm) and to the supra-orbital ridge was 101 mm (75–125 mm). The mean intracranial catheter length was 60 mm (from 39–102 mm). Only 50% of the EVDs in the coronal plane and 40% in the sagittal plane were placed with an angular variation of ±5° to the target. The tip was placed outside of the ventricles in three cases; 13 catheters crossed the midline, and five intracranial minor haemorrhages were detected.

Conclusion

Freehand placement of EVDs does not have sufficient accuracy and may lead to drainage dysfunctions. This data suggests that a guidance system for EVD’s would be required.

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Authors and Affiliations

  1. Department of Neurosurgery, University Paris East, Medical School, Assitance Publique - Hôpitaux de Paris, Henri Mondor Hospital, Créteil, France

    Mohammad Ghazi Abdoh, Olivier Bekaert, Salia Mamadou Diarra, Caroline Le Guerinel, Rémi Nseir & Philippe Decq

  2. Department of Neuroradiology, University Paris East, Medical School, Assitance Publique - Hôpitaux de Paris, Henri Mondor Hospital, Créteil, France

    Jérôme Hodel

  3. Clinical investigation laboratory, University Paris East, Medical School, Assitance Publique - Hôpitaux de Paris, Henri Mondor Hospital, Créteil, France

    Sylvie Bastuji-Garin

  4. Faculté de Médecine PARIS 12, Assistance Publique—Hôpitaux de Paris, Service de Neurochirurgie, Hôpital Henri-Mondor, 51 Bd du Maréchal de Lattre de tassigny, 94010, Creteil Cedex, France

    Philippe Decq

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  1. Mohammad Ghazi Abdoh
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  2. Olivier Bekaert
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  4. Salia Mamadou Diarra
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  5. Caroline Le Guerinel
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  8. Philippe Decq
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Correspondence to Philippe Decq.

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Abdoh, M.G., Bekaert, O., Hodel, J. et al. Accuracy of external ventricular drainage catheter placement. Acta Neurochir 154, 153–159 (2012). https://doi.org/10.1007/s00701-011-1136-9

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  • DOI: https://doi.org/10.1007/s00701-011-1136-9

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