Hollow mandrin facilitates external ventricular drainage placement.

Hollow mandrin facilitates external ventricular drainage placement. Research Abstract Details 

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Hollow mandrin facilitates external ventricular drainage placement. Abstract Text:

O Heese,J Regelsberger,U Kehler,M Westphal,O Heese,J Regelsberger,U Kehler,M Westphal,O Heese,J Regelsberger,U Kehler,M Westphal,

BACKGROUND: Placement of ventricular catheters is a routine procedure in neurosurgery. Ventricle puncture is done using a flexible ventricular catheter stabilised by a solid steel mandrin in order to improve stability during brain penetration. A correct catheter placement is confirmed after removing the solid steel mandrin by observation of cerebrospinal fluid (CSF) flow out of the flexible catheter. Incorrect placement makes further punctures necessary. The newly developed device allows CSF flow observation during the puncture procedure and in addition precise intracranial pressure (ICP) measurement. METHOD: The developed mandrin is hollow with a blunt tip. On one side 4-5 small holes with a diameter of 0.8 mm are drilled corresponding exactly with the holes in the ventricular catheter, allowing CSF to pass into the hollow mandrin as soon as the ventricle is reached. By connecting a small translucent tube at the distal portion of the hollow mandrin ICP can be measured without loss of CSF. The system has been used in 15 patients with subarachnoid haemorrhage (SAH) or intraventricular haemeorrhage (IVH) and subsequent hydrocephalus. FINDINGS: The new system improved the external ventricular drainage implantation procedure. In all 15 patients catheter placement was correct. ICP measurement was easy to perform immediately at ventricle puncture. In 4 patients at puncture no spontaneous CSF flow was observed, therefore by connecting a syringe and gentle aspiration of CSF correct placement was confirmed in this unexpected low pressure hydrocephalus. Otherwise by using the conventional technique further punctures would have been necessary. CONCLUSIONS: Advantages of the new technique are less puncture procedures with a lower risk of damage to neural structures and reduced risk of intracranial haemorrhages. Implantation of the ventricular catheter to far into the brain can be monitored and this complication can be overcome. Using the connected pressure monitoring tube an exact measurement of the opening intracranial pressure can be obtained performed without losing CSF.

Hollow mandrin facilitates external ventricular drainage placement. Publishing Authors By Initials

O Heese,J Regelsberger,U Kehler,M Westphal,O Heese,J Regelsberger,U Kehler,M Westphal,O Heese,J Regelsberger,U Kehler,M Westphal,

For similar surgical procedures, operative: anastomosis, surgical: cerebrospinal fluid shunts: ventriculostomy research abstracts see: surgical procedures, operative: anastomosis, surgical: cerebrospinal fluid shunts: ventriculostomy research

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Hollow mandrin facilitates external ventricular drainage placement. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Acta neurochirurgica

VOLUME: 147

Page Numbers: 759-62; discussion 762

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ISSN: 0942-0940

DAY: 10

MONTH: 03

YEAR: 2005

Hollow mandrin facilitates external ventricular drainage placement. Information

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LANGUAGE: eng

NlmUniqueID: 151000

Hollow mandrin facilitates external ventricular drainage placement. Keywords Mesh Terms:

KEYWORDS: Ventriculostomy

MESH TERMS: instrumentation

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Grant and Affiliation Information for Hollow mandrin facilitates external ventricular drainage placement.

AFFILIATION: Department of Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany. heese@uke.uni-hamburg.de

Country: Austria

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MEDLINETA: Acta Neurochir (Wien)

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