Skip to main content
SpringerLink
Log in

External CSF Shunts

  • Living reference work entry
  • First Online:
Textbook of Pediatric Neurosurgery

  • 846 Accesses

Abstract

The insertion of an external ventricular drainage (EVD) is a common practice in neurosurgery, especially in pediatrics. This approach has been developed and evolved in the last century and is currently considered a standard technique.

However, in spite of this standardization, EVD placement can be associated with different complications, and the infection is the most important one, with significant associated morbidity and mortality.

The present chapter summarizes the main aspects about EVDs in the pediatric population, emphasizing in the indications for its insertion, its complications, and the protocols to avoid bad functional results.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Bibliography

  • Abla AA, Zabramski JM, Jahnke HK, Fusco D, Nakaji P (2011) Comparison of two antibiotic-impregnated ventricular catheters: a prospective sequential series trial. Neurosurgery 68(2):437–442; discussion 442

    Article  PubMed  Google Scholar 

  • Aitken AR (1996) A ventricular catheter guide for rapid and accurate ventricular access. J Clin Neurosci 3(3):257–260

    Article  CAS  PubMed  Google Scholar 

  • Arabi Y, Memish ZA, Balkhy HH, Francis C, Ferayan A, Al Shimemeri A, Almuneef MA (2005) Ventriculostomy-associated infections: incidence and risk factors. Am J Infect Control 33(3):137–143

    Article  PubMed  Google Scholar 

  • Aschoff A, Kremer P, Hashemi B, Kunze S (1999) The scientific history of hydrocephalus and its treatment. Neurosurg Rev 22(2–3):67–93; discussion 94–65

    Article  CAS  PubMed  Google Scholar 

  • Atkinson RA, Fikrey L, Vail A, Patel HC (2016) Silver-impregnated external-ventricular-drain-related cerebrospinal fluid infections: a meta-analysis. J Hosp Infect 92(3):263–72

    Google Scholar 

  • Bassan H, Eshel R, Golan I, Kohelet D, Ben Sira L, Mandel D, Levi L, Constantini S, Beni-Adani L, External Ventricular Drainage Study Investigators (2012) Timing of external ventricular drainage and neurodevelopmental outcome in preterm infants with posthemorrhagic hydrocephalus. Eur J Paediatr Neurol 16(6):662–670

    Article  PubMed  Google Scholar 

  • Bauer, D. F., G. McGwin, Jr., S. M. Melton, R. L. George and J. M. Markert (2011). The relationship between INR and development of hemorrhage with placement of ventriculostomy. J Trauma 70(5): 1112–1117.

    Google Scholar 

  • Bergdal O, Springborg JB, Holst AV, Hauerberg J, Way S, Breum P, Romner B (2013) Accuracy of tunnelated vs. bolt-connected external ventricular drains. Clin Neurol Neurosurg 115(10):1972–1975

    Article  PubMed  Google Scholar 

  • Berger A, Weninger M, Reinprecht A, Haschke N, Kohlhauser C, Pollak A (2000) Long-term experience with subcutaneously tunneled external ventricular drainage in preterm infants. Childs Nerv Syst 16(2):103–109. discussion 110

    Article  CAS  PubMed  Google Scholar 

  • Caldarelli M, Di Rocco C, La Marca F (1996) Shunt complications in the first postoperative year in children with meningomyelocele. Childs Nerv Syst 12(12):748–754

    Article  CAS  PubMed  Google Scholar 

  • Chai FY, Farizal F, Jegan T (2013) Coma due to malplaced external ventricular drain. Turk Neurosurg 23(4):561–563

    PubMed  Google Scholar 

  • Cinibulak Z, Aschoff A, Apedjinou A, Kaminsky J, Trost HA, Krauss JK (2016) Current practice of external ventricular drainage: a survey among neurosurgical Departments in Germany. Acta Neurochir 158:847–853

    Article  PubMed  Google Scholar 

  • Collins CD, Hartley JC, Chakraborty A, Thompson DN (2014) Long subcutaneous tunnelling reduces infection rates in paediatric external ventricular drains. Childs Nerv Syst 30(10):1671–1678

    Article  PubMed  PubMed Central  Google Scholar 

  • Cornips E, Van Calenbergh F, Plets C, Devlieger H, Casaer P (1997) Use of external drainage for posthemorrhagic hydrocephalus in very low birth weight premature infants. Childs Nerv Syst 13(7):369–374

    Article  CAS  PubMed  Google Scholar 

  • Dandy WE (1918) Ventriculography Following the Injection of Air into the Cerebral Ventricles. Ann Surg 68(1):5–11

    Google Scholar 

  • Dash C, Gurjar H, Garg K, Sharma BS, Singla R (2016) Massive life-threatening bifrontal epidural hematoma following placement of an external ventricular drain. Childs Nerv Syst 32(2):237–239

    Article  PubMed  Google Scholar 

  • Dasic D, Hanna SJ, Bojanic S, Kerr RS (2006) External ventricular drain infection: the effect of a strict protocol on infection rates and a review of the literature. Br J Neurosurg 20(5):296–300

    Article  CAS  PubMed  Google Scholar 

  • Di Rocco F, Juca CE, Zerah M, Sainte-Rose C (2013) Endoscopic third ventriculostomy and posterior fossa tumors. World Neurosurg 79(2 Suppl):S18. e15–19

    PubMed  Google Scholar 

  • Edwards NC, Engelhart L, Casamento EM, McGirt MJ (2015) Cost-consequence analysis of antibiotic-impregnated shunts and external ventricular drains in hydrocephalus. J Neurosurg 122(1):139–147

    Article  PubMed  Google Scholar 

  • Flint AC, Rao VA, Renda NC, Faigeles BS, Lasman TE, Sheridan W (2013) A simple protocol to prevent external ventricular drain infections. Neurosurgery 72(6):993–999; discussion 999

    Article  PubMed  Google Scholar 

  • Fried HI, Nathan BR, Rowe AS, Zabramski JM, Andaluz N, Bhimraj A, Guanci MM, Seder DB, Singh JM (2016) The insertion and management of external ventricular drains: an evidence-based consensus statement: a statement for healthcare professionals from the Neurocritical Care Society. Neurocrit Care 24(1):61–81

    Article  PubMed  Google Scholar 

  • Friedman WA, Vries JK (1980) Percutaneous tunnel ventriculostomy. Summary of 100 procedures. J Neurosurg 53(5):662–665

    Article  CAS  PubMed  Google Scholar 

  • Fritsch MJ, Doerner L, Kienke S, Mehdorn HM (2005) Hydrocephalus in children with posterior fossa tumors: role of endoscopic third ventriculostomy. J Neurosurg 103(1 Suppl):40–42

    PubMed  Google Scholar 

  • Hader WJ, Steinbok P (2000) The value of routine cultures of the cerebrospinal fluid in patients with external ventricular drains. Neurosurgery 46(5):1149–1153; discussion 1153–1145

    Article  CAS  PubMed  Google Scholar 

  • Hepburn-Smith M, Dynkevich I, Spektor M, Lord A, Czeisler B, Lewis A (2016) Establishment of an external ventricular drain best practice guideline: the quest for a comprehensive, universal standard for external ventricular drain care. J Neurosci Nurs 48(1):54–65

    Article  PubMed  Google Scholar 

  • Huyette DR, Turnbow BJ, Kaufman C, Vaslow DF, Whiting BB, Oh MY (2008) Accuracy of the freehand pass technique for ventriculostomy catheter placement: retrospective assessment using computed tomography scans. J Neurosurg 108(1):88–91

    Article  PubMed  Google Scholar 

  • Hyun SJ, Suk JS, Kwon JT, Kim YB (2007) Novel entry point for intraoperative ventricular puncture during the transsylvian approach. Acta Neurochir 149(10):1049–1051; discussion 1051

    Article  CAS  PubMed  Google Scholar 

  • Jakola AS, Reinertsen I, Selbekk T, Solheim O, Lindseth F, Gulati S, Unsgard G (2014) Three-dimensional ultrasound-guided placement of ventricular catheters. World Neurosurg 82(3–4):536. e535–539

    PubMed  Google Scholar 

  • Januschek E, Machado LS, Steinthal B, Ulrich PT (2011) Posthemorrhagic hydrocephalus in very low birth weight infants--a new gentle surgical technique for external ventricular drainage. Childs Nerv Syst 27(6):991–994

    Article  PubMed  Google Scholar 

  • Ji C, Ahn JG (2010) Multiple intracranial calcifications as a complication of external ventricular drain placement. J Korean Neurosurg Soc 47(2):158–160

    Google Scholar 

  • Kakarla UK, Kim LJ, Chang SW, Theodore N, Spetzler RF (2008) Safety and accuracy of bedside external ventricular drain placement. Neurosurgery 63(1 Suppl 1):ONS162–ONS166; discussion ONS166–167

    PubMed  Google Scholar 

  • Kaufmann GE, Clark K (1970) Emergency frontal twist drill ventriculostomy. Technical note. J Neurosurg 33(2):226–227

    Article  CAS  PubMed  Google Scholar 

  • Keong NC, Bulters DO, Richards HK, Farrington M, Sparrow OC, Pickard JD, Hutchinson PJ, Kirkpatrick PJ (2012) The SILVER (Silver impregnated line versus EVD randomized trial): a double-blind, prospective, randomized, controlled trial of an intervention to reduce the rate of external ventricular drain infection. Neurosurgery 71(2):394–403; discussion 403–394

    Article  PubMed  Google Scholar 

  • Khalil BA, Sarsam Z, Buxton N (2005) External ventricular drains: is there a time limit in children? Childs Nerv Syst 21(5):355–357

    Article  PubMed  Google Scholar 

  • Kochanek PM, Carney N, Adelson PD, Ashwal S, Bell MJ, Bratton S, Carson S, Chesnut RM, Ghajar J, Goldstein B, Grant GA, Kissoon N, Peterson K, Selden NR, Tasker RC, Tong KA, Vavilala MS, Wainwright MS, Warden CR, American Academy of Pediatrics-Section on Neurological Surgery, American Association of Neurological Surgeons/Congress of Neurological Surgeons, Child Neurology Society, European Society of Pediatric, Neonatal Intensive Care, Neurocritical Care Society, Pediatric Neurocritical Care Research Group, Society of Critical Care Medicine, Paediatric Intensive Care Society UK, Society for Neuroscience in Anesthesiology and Critical Care, World Federation of Pediatric Intensive and Critical Care Societies (2012) Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents–second edition. Pediatr Crit Care Med 13(Suppl 1):S1–82

    PubMed  Google Scholar 

  • Konstantelias AA, Vardakas KZ, Polyzos KA, Tansarli GS, Falagas ME (2015) Antimicrobial-impregnated and -coated shunt catheters for prevention of infections in patients with hydrocephalus: a systematic review and meta-analysis. J Neurosurg 122(5):1096–1112

    Article  PubMed  Google Scholar 

  • Korinek AM, Reina M, Boch AL, Rivera AO, De Bels D, Puybasset L (2005) Prevention of external ventricular drain–related ventriculitis. Acta Neurochir 147(1):39–45. discussion 45-36

    Article  PubMed  Google Scholar 

  • Kubilay Z, Amini S, Fauerbach LL, Archibald L, Friedman WA, Layon AJ (2013) Decreasing ventricular infections through the use of a ventriculostomy placement bundle: experience at a single institution. J Neurosurg 118(3):514–520

    Article  PubMed  Google Scholar 

  • Lee CK, Tay LL, Ng WH, Ng I, Ang BT (2008) Optimization of ventricular catheter placement via posterior approaches: a virtual reality simulation study. Surg Neurol 70(3):274–277. discussion 277-278

    Article  PubMed  Google Scholar 

  • Leung GK, Ng KB, Taw BB, Fan YW (2007) Extended subcutaneous tunnelling technique for external ventricular drainage. Br J Neurosurg 21(4):359–364

    Article  CAS  PubMed  Google Scholar 

  • Leverstein-van Hall MA, Hopmans TE, van der Sprenkel JW, Blok HE, van der Mark WA, Hanlo PW, Bonten MJ (2010) A bundle approach to reduce the incidence of external ventricular and lumbar drain-related infections. J Neurosurg 112(2):345–353

    Article  PubMed  Google Scholar 

  • Lo CH, Spelman D, Bailey M, Cooper DJ, Rosenfeld JV, Brecknell JE (2007) External ventricular drain infections are independent of drain duration: an argument against elective revision. J Neurosurg 106(3):378–383

    Article  PubMed  Google Scholar 

  • Lozier AP, Sciacca RR, Romagnoli MF, Connolly ES Jr (2002) Ventriculostomy-related infections: a critical review of the literature. Neurosurgery 51(1):170–181. discussion 181-172

    Article  PubMed  Google Scholar 

  • Madrazo Navarro I, Garcia Renteria JA, Rosas Peralta VH, Dei Castilli MA (1981) Transorbital ventricular puncture for emergency ventricular decompression. Technical note. J Neurosurg 54(2):273–274

    Article  CAS  PubMed  Google Scholar 

  • Massimi L, Di Rocco C (2013) Surgical treatment of posthemorrhagic infantile hydrocephalus. Minerva Pediatr 65(4):417–425

    CAS  PubMed  Google Scholar 

  • Mayhall CG, Archer NH, Lamb VA, Spadora AC, Baggett JW, Ward JD, Narayan RK (1984) Ventriculostomy-related infections. A prospective epidemiologic study. N Engl J Med 310(9):553–559

    Article  CAS  PubMed  Google Scholar 

  • Mazzola CA, Choudhri AF, Auguste KI, Limbrick DD, Rogido M Jr, Mitchell L, Flannery AM, Pediatric Hydrocephalus Systematic Review, Evidence-Based Guidelines Task Force (2014) Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 2: management of posthemorrhagic hydrocephalus in premature infants. J Neurosurg Pediatr 14(Suppl 1):8–23

    Article  PubMed  Google Scholar 

  • McGirt MJ, Leveque JC, Wellons JC 3rd, Villavicencio AT, Hopkins JS, Fuchs HE, George TM (2002) Cerebrospinal fluid shunt survival and etiology of failures: a seven-year institutional experience. Pediatr Neurosurg 36(5):248–255

    Article  PubMed  Google Scholar 

  • Menovsky T, De Vries J, Wurzer JA, Grotenhuis JA (2006) Intraoperative ventricular puncture during supraorbital craniotomy via an eyebrow incision. Technical note. J Neurosurg 105(3):485–486

    Article  PubMed  Google Scholar 

  • Ngo QN, Ranger A, Singh RN, Kornecki A, Seabrook JA, Fraser DD (2009) External ventricular drains in pediatric patients. Pediatr Crit Care Med 10(3):346–351

    Article  PubMed  Google Scholar 

  • O’Leary ST, Kole MK, Hoover DA, Hysell SE, Thomas A, Shaffrey CI (2000) Efficacy of the Ghajar guide revisited: a prospective study. J Neurosurg 92(5):801–803

    Article  PubMed  Google Scholar 

  • Omar MA, Mohd Haspani MS (2010) The risk factors of external ventricular drainage-related infection at hospital kuala lumpur: an observational study. Malays J Med Sci 17(3):48–54

    PubMed  PubMed Central  Google Scholar 

  • O’Neill BR, Velez DA, Braxton EE, Whiting D, Oh MY (2008) A survey of ventriculostomy and intracranial pressure monitor placement practices. Surg Neurol 70(3):268–273; discussion 273

    Article  PubMed  Google Scholar 

  • Paine JT, Batjer HH, Samson D (1988) Intraoperative ventricular puncture. Neurosurgery 22(6 Pt 1):1107–1109

    Article  CAS  PubMed  Google Scholar 

  • Park YG, Woo HJ, Kim E, Park J (2011) Accuracy and safety of bedside external ventricular drain placement at two different cranial sites: Kocher's point versus forehead. J Korean Neurosurg Soc 50(4):317–321

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Phillips SB, Delly F, Nelson C, Krishnamurthy S (2014) Bedside external ventricular drain placement: can multiple passes be predicted on the computed tomography scan before the procedure? World Neurosurg 82(5):739–744

    Article  PubMed  Google Scholar 

  • Pople I, Poon W, Assaker R, Mathieu D, Iantosca M, Wang E, Zhang LW, Leung G, Chumas P, Menei P, Beydon L, Hamilton M, Kamaly I, Lewis S, Ning W, Megerian JT, McGirt MJ, Murphy JA, Michael A, Meling T (2012) Comparison of infection rate with the use of antibiotic-impregnated vs standard extraventricular drainage devices: a prospective, randomized controlled trial. Neurosurgery 71(1):6–13

    Article  PubMed  Google Scholar 

  • Prabhakar H, Ali Z, Rath GP, Bithal PK (2008) Tension pneumocephalus following external ventricular drain insertion. J Anesth 22(3):326–327

    Google Scholar 

  • Rivero-Garvia M, Marquez-Rivas J, Jimenez-Mejias ME, Neth O, Rueda-Torres AB (2011) Reduction in external ventricular drain infection rate. Impact of a minimal handling protocol and antibiotic-impregnated catheters. Acta Neurochir 153(3):647–651

    Article  PubMed  Google Scholar 

  • Ruggiero C, Cinalli G, Spennato P, Aliberti F, Cianciulli E, Trischitta V, Maggi G (2004) Endoscopic third ventriculostomy in the treatment of hydrocephalus in posterior fossa tumors in children. Childs Nerv Syst 20(11–12):828–833

    Article  PubMed  Google Scholar 

  • Saladino A, White JB, Wijdicks EF, Lanzino G (2009) Malplacement of ventricular catheters by neurosurgeons: a single institution experience. Neurocrit Care 10(2):248–252

    Article  PubMed  Google Scholar 

  • Saunders RL, Lyons TA (1979) External ventricular drainage. A technical note. Crit Care Med 7(12):556–558

    Article  CAS  PubMed  Google Scholar 

  • Schade RP, Schinkel J, Roelandse FW, Geskus RB, Visser LG, van Dijk JM, Voormolen JH, Van Pelt H, Kuijper EJ (2006) Lack of value of routine analysis of cerebrospinal fluid for prediction and diagnosis of external drainage-related bacterial meningitis. J Neurosurg 104(1):101–108

    Article  PubMed  Google Scholar 

  • Schaumann A, Thomale UW (2013) Guided application of ventricular catheters (GAVCA) –multicentre study to compare the ventricular catheter position after use of a catheter guide versus freehand application: study protocol for a randomised trail. Trials 14:428

    Article  PubMed  PubMed Central  Google Scholar 

  • Schirmer CM, Elder JB, Roitberg B, Lobel DA (2013) Virtual reality-based simulation training for ventriculostomy: an evidence-based approach. Neurosurgery 73(Suppl 1):66–73

    Article  PubMed  Google Scholar 

  • Schodel P, Proescholdt M, Ullrich OW, Brawanski A, Schebesch KM (2012) An outcome analysis of two different procedures of burr-hole trephine and external ventricular drainage in acute hydrocephalus. J Clin Neurosci 19(2):267–270

    Article  PubMed  Google Scholar 

  • Sekula RF, Cohen DB, Patek PM, Jannetta PJ, Oh MY (2008) Epidemiology of ventriculostomy in the United States from 1997 to 2001. Br J Neurosurg 22(2):213–218

    Article  CAS  PubMed  Google Scholar 

  • Shekhar H, Kalsi P, Dambatta S, Strachan R (2015) Do antibiotic-impregnated external ventriculostomy catheters have a low infection rate in clinical practice? A retrospective cohort study. Br J Neurosurg 30(1):64–69

    Google Scholar 

  • Sonabend AM, Korenfeld Y, Crisman C, Badjatia N, Mayer SA, Connolly ES Jr (2011) Prevention of ventriculostomy-related infections with prophylactic antibiotics and antibiotic-coated external ventricular drains: a systematic review. Neurosurgery 68(4):996–1005

    Article  PubMed  Google Scholar 

  • Srinivasan VM, O’Neill BR, Jho D, Whiting DM, Oh MY (2014) The history of external ventricular drainage. J Neurosurg 120(1):228–236

    Article  PubMed  Google Scholar 

  • Stevens EA, Palavecino E, Sherertz RJ, Shihabi Z, Couture DE (2010) Effects of antibiotic-impregnated external ventricular drains on bacterial culture results: an in vitro analysis. J Neurosurg 113(1):86–92

    Article  PubMed  Google Scholar 

  • Tai BL, Rooney D, Stephenson F, Liao PS, Sagher O, Shih AJ, Savastano LE (2015) Development of a 3D-printed external ventricular drain placement simulator: technical note. J Neurosurg 123(4):1070–1076

    Article  PubMed  Google Scholar 

  • Tamburrini G, Massimi L, Caldarelli M, Di Rocco C (2008a) Antibiotic impregnated external ventricular drainage and third ventriculostomy in the management of hydrocephalus associated with posterior cranial fossa tumours. Acta Neurochir 150(10):1049–1055; discussion 1055–1046

    Article  PubMed  Google Scholar 

  • Tamburrini G, Pettorini BL, Massimi L, Caldarelli M, Di Rocco C (2008b) Endoscopic third ventriculostomy: the best option in the treatment of persistent hydrocephalus after posterior cranial fossa tumour removal? Childs Nerv Syst 24(12):1405–1412

    Article  CAS  PubMed  Google Scholar 

  • Thomale UW, Knitter T, Schaumann A, Ahmadi SA, Ziegler P, Schulz M, Miethke C (2013) Smartphone-assisted guide for the placement of ventricular catheters. Childs Nerv Syst 29(1):131–139

    Article  CAS  PubMed  Google Scholar 

  • Thomas R, Lee S, Patole S, Rao S (2012) Antibiotic-impregnated catheters for the prevention of CSF shunt infections: a systematic review and meta-analysis. Br J Neurosurg 26(2):175–184

    Article  PubMed  Google Scholar 

  • Toma AK, Camp S, Watkins LD, Grieve J, Kitchen ND (2009) External ventricular drain insertion accuracy: is there a need for change in practice? Neurosurgery 65(6):1197–1200; discussion 1200–1191

    Article  PubMed  Google Scholar 

  • Tronnier V, Aschoff A, Hund E, Hampl J, Kunze S (1991) Commercial external ventricular drainage sets: unsolved safety and handling problems. Acta Neurochir 110(1–2):49–56

    Article  CAS  PubMed  Google Scholar 

  • Tubbs RS, Loukas M, Shoja MM, Cohen-Gadol AA (2009) Emergency transorbital ventricular puncture: refinement of external landmarks. J Neurosurg 111(6):1191–1192

    Article  PubMed  Google Scholar 

  • Wang X, Dong Y, Qi XQ, Li YM, Huang CG, Hou LJ (2013) Clinical review: efficacy of antimicrobial-impregnated catheters in external ventricular drainage – a systematic review and meta-analysis. Crit Care 17(4):234

    Article  PubMed  PubMed Central  Google Scholar 

  • Weninger M, Salzer HR, Pollak A, Rosenkranz M, Vorkapic P, Korn A, Lesigang C (1992) External ventricular drainage for treatment of rapidly progressive posthemorrhagic hydrocephalus. Neurosurgery 31(1):52–57; discussion 57-58

    CAS  PubMed  Google Scholar 

  • Winkler KM, Woernle CM, Seule M, Held U, Bernays RL, Keller E (2013) Antibiotic-impregnated versus silver-bearing external ventricular drainage catheters: preliminary results in a randomized controlled trial. Neurocrit Care 18(2):161–165

    Article  CAS  PubMed  Google Scholar 

  • Woernle CM, Burkhardt JK, Bellut D, Krayenbuehl N, Bertalanffy H (2011) Do iatrogenic factors bias the placement of external ventricular catheters?–A single institute experience and review of the literature. Neurol Med Chir (Tokyo) 51(3):180–186

    Article  Google Scholar 

  • Wong GK, Poon WS, Wai S, Yu LM, Lyon D, Lam JM (2002) Failure of regular external ventricular drain exchange to reduce cerebrospinal fluid infection: result of a randomised controlled trial. J Neurol Neurosurg Psychiatry 73(6):759–761

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Yudkowsky R, Luciano C, Banerjee P, Schwartz A, Alaraj A, Lemole GM Jr, Charbel F, Smith K, Rizzi S, Byrne R, Bendok B, Frim D (2013) Practice on an augmented reality/haptic simulator and library of virtual brains improves residents’ ability to perform a ventriculostomy. Simul Healthc 8(1):25–31

    Article  PubMed  Google Scholar 

  • Zabramski JM, Whiting D, Darouiche RO, Horner TG, Olson J, Robertson C, Hamilton AJ (2003) Efficacy of antimicrobial-impregnated external ventricular drain catheters: a prospective, randomized, controlled trial. J Neurosurg 98(4):725–730

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurosurgery Department, Hospital Universitario de Canarias, La Laguna, Spain

    Mario Garcia-Conde, Julio Plata-Bello & Liberto Brage-Martin

  2. Pediatric Department, Hospital Universitario Nuestra Señora de la Canderaria, Santa Cruz de Tenerife, Spain

    Lucia Martin-Viota

Authors
  1. Mario Garcia-Conde
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julio Plata-Bello
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Liberto Brage-Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lucia Martin-Viota
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mario Garcia-Conde .

Editor information

Editors and Affiliations

  1. International Neuroscience Institute, Hannover, Germany

    Concezio Di Rocco

  2. Oakland Medical Center, Oakland, California, USA

    Dachling Pang

  3. University of Toronto Hospital for Sick Children, Toronto, Ontario, Canada

    James T. Rutka

Section Editor information

  1. Director of Pediatric Neurosurgery, International Neuroscience Institute, Hannover, Germany

    Concezio Di Rocco

  2. Pediatric Neurosurgery, Institute of Neurosurgery, Catholic University Medical School, Largo “A. Gemelli”,8, 00168, Rome, Italy

    Gianpiero Tamburrini

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this entry

Cite this entry

Garcia-Conde, M., Plata-Bello, J., Brage-Martin, L., Martin-Viota, L. (2017). External CSF Shunts. In: Di Rocco, C., Pang, D., Rutka, J. (eds) Textbook of Pediatric Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-31512-6_32-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-31512-6_32-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31512-6

  • Online ISBN: 978-3-319-31512-6

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

Publish with us

Policies and ethics

Search

Navigation