Definition
Placement of an open catheter through the skull and into a ventricle of the brain, draining cerebrospinal fluid externally.
Current Knowledge
External ventricular drains (EVDs) aka ventricular catheter (“ventrics”) are used routinely for monitoring and treating patients with subarachnoid hemorrhage, intraventricular hemorrhage, mass lesions, and traumatic brain injury. In intracranial hemorrhage, obstruction of cerebrospinal fluid (CSF) drainage pathways by blood can lead to acute hydrocephalus and/or elevated intracranial pressure. EVD placement allows for temporary diversion of CSF flow during the acute period of hydrocephalus. In time, CSF flow dynamics may return to normal in many of these patients, allowing the EVD to be discontinued without the need for a permanent shunt. In others, however, chronic hydrocephalus develops and placement of an internalized ventriculoperitoneal shunt may be necessary.
Intracranial pressure (ICP) monitoring is a standard intervention for...
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References and Readings
Fried, H. I., Nathan, B. R., Rowe, A. S., Zabramski, J. M., Andaluz, N., Bhimraj, A., et al. (2016). The insertion and management of external ventricular drains: An evidence-based consensus statement. Neurocritical Care, 24(1), 61–81.
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Soumitra, R. E. (Ed.). (2009). In Merck manual online. Critical care medicine approach to the critically ill patient patient monitoring and testing. Hagerstown: Lippincott.
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Ladley, S., Zasler, N.D. (2018). Ventriculostomy. In: Kreutzer, J.S., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-57111-9_80
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DOI: https://doi.org/10.1007/978-3-319-57111-9_80
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