Ventricular Drainage Sets Can Be Used Following Tumor Surgery, Until CSF Circulation Is Re-Established

 

Ventricular drainage sets use a combination of gravity and intercerebral pressure to drain CSF. The drainage rate depends on the height at which the External Ventricular Drain (EVD) system is placed relative to the patient's anatomy. Neurosurgeons or neurointensivists use EVD to divert fluid from the ventricles of the brain and allow for monitoring of intracranial pressure.

Ventricular drainage sets can be used following tumor surgery, until the CSF circulation is re-established and to drain infected CSF during the treatment of meningitis. It is also used in patients with a severe head injury to provide both a means of measuring continuous intracranial pressure and allowing CSF drainage to treat raised continuous intracranial pressure. To an EVD, the patient is positioned with head/torso at 45° angle relative to the floor and his/her frontal scalp is shaved. Surgeons mark Kocher point (approximately 11 cm from the nasion and 3 cm from the midpupillary line) and prepp and drape patient in the usual sterile fashion. Surgeons collect regular CSF samples to proactively monitor development of infection in the setting of EVD. An EVD should not cause pain however paracetamol will be available as needed. Drainage should not be turned off for longer than needed, as this can cause the catheter to block.

High prevalence of hemorrhage boosts demand for ventricular drainage sets. Intracerebral haemorrhage is a common cause of stroke that displays a worldwide incidence of 24.6 per 100,000 person-years. Epidemiologic studies indicate that approximately 87% of strokes in the U.S. are ischemic, 10% are secondary to intracerebral hemorrhage, and another 3% may be secondary to subarachnoid hemorrhage. Increased intracranial pressure and acute hydrocephalus caused by intracerebral hemorrhage is managed by placement of an EVD.