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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Accuracy and complications of ventriculostomy using two different procedures of external ventricular drainage – a single center series

Meeting Abstract

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  • Christian Wispel - Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität, Bonn
  • Patrick Schuss - Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität, Bonn
  • Valeri Borger - Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität, Bonn
  • Ági Oszvald - Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität, Bonn
  • Hartmut Vatter - Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität, Bonn
  • Erdem Güresir - Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität, Bonn

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.12.04

doi: 10.3205/14dgnc336, urn:nbn:de:0183-14dgnc3366

Published: May 13, 2014

© 2014 Wispel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Patients suffering from acute hydrocephalus are treated by either insertion of classic external ventricular drainage (EVD) or percutaneous needle trephination (PNT) at our institution, depending on the acuteness of intervention and severity of illness. We compared both procedures regarding factors necessitating surgical revision of EVD or PNT.

Method: Between January 2012 and September 2013, 356 patients suffering from acute hydrocephalus underwent ventriculostomy at our institution. All patients had a routine CT-scan after insertion of the ventricular drain during the treatment course. Patient characteristics, underlying pathology, treatment modality, radiological features, catheter tip location and treatment-related complications were analysed in retrospect.

Results: Overall, 251 of 356 patients (71%) were treated by EVD, and 105 patients (29%) by PNT. 53 patients with EVD (21%) versus 14 patients with PNT (13%) underwent surgical revision due to misplacement, accidental removal, or infection. However, complication and revision rates did not differ significantly between the two groups. Furthermore, there was no difference between between EVD and PNT (p=0.5 regarding ventriculostomy-related hemorrhage.

Conclusions: The present data indicate that percutaneous needle trephination can equally lsafely used in critically ill patients, a who need immediate treatment for acute hydrocephalus. Nevertheless, classic external ventricular drainage might be preferred in less critical situations or if needed for longer period during the course of the treatment.