Accuracy of the Free Hand Placement of an External Ventricular Drain (EVD)
|
|
- Bonnie Henderson
- 5 years ago
- Views:
Transcription
1 KOR J CEREBROVASCULAR SURGERY June 2O10 Vol. 12 No 2, page 82-6 Accuracy of the Free Hand Placement of an External Ventricular Drain (EVD) Department of Neurosurgery, Gachon University of Medicine & Science, Gil Medical Center, Incheon, South Korea Ji - Hoon Lee, MD Cheol - Wan Park, MD, PhD Uhn Lee MD Young - Bo Kim MD Chan - Jong Yoo, MD Eun - Young Kim, MD Jae - Myung Kim, MD Woo - Kyung Kim, MD ABSTRACT Objective : Free hand insertion of an external ventricular drain (EVD) is one of the most common emergency neurosurgical procedures, usually performed on critically ill patients. Complications such as infection and hemorrhage that accompany the placement of an EVD have been studied thoroughly, but few reports have focused on the accuracy of EVD positioning. As a result, the authors of this paper retrospectively studied the accuracy of tip positioning in the placement of an EVD. Methods : One hundred and thirteen emergency EVDs were performed through Kocher s point during the past 3 years. All patients underwent the following procedures: at least one routine post- EVD computed tomographic (CT) scan that was retrospectively reviewed for accuracy of the EVD tip position, calculation of the Evan s index, and measurement of the intracranial length of the EVD. We divided the EVD tip position into 6 groups as follows:1) ipsilateral frontal horn of the lateral ventricle, 2) contralateral frontal horn of the lateral ventricle, 3) third ventricle, 4) body of the ipsilateral or contralateral lateral ventricle, 5) basal cisterns, or 6) brain parenchyma. Among the 6 groups, only the ipsilateral frontal horn group was considered to be the correct position for the EVD tip. Results : The mean age of the patients was years (age range, 12~90 years), and the most common indication for the EVD was supratentorial intracerebral hemorrhage (ICH) and intraventricular hemorrhage (IVH) (57.5%). Fortyfive out of a total of 113 EVDs were placed by inexperienced neurosurgical trainees, and the remaining 68 were placed by experienced practitioners. Among 113 post-evd CT scans, 48 EVD tips (42.5%) were in the ipsilateral frontal horn of the lateral ventricle (considered to be the correct position); 22 (19.5%) were in the third ventricle, 16 (14.1%) in the body of the ipsilateral or contralateral lateral ventricle, 14 (12.4%) in the contralateral frontal horn of the lateral ventricle, 11 (9.7%) within the brain parenchyma and 2 (1.8%) in the basal cistern. The mean estimated EVD length was mm. The mean length of EVDs that were positioned in the ipsilateral frontal horn was mm, whereas the mean lengths of EVDs in the parenchyma and basal cistern were 64 14mm and mm, respectively. In addition, there was no statistically significant relationship between the surgeon s experience and the accuracy of the position of the EVD tip (p > 0.05). Conclusion : Emergency free hand placement of an EVD might be an inaccurate procedure. Further multi-institutional prospective studies are required to assess the accuracy and complications of free hand insertion of EVDs in an emergency setting. Studies are also needed on the feasibility of routine use of intra-operative neuro-navigation of other guidance tools, such as ultrasonography. (Kor J Cerebrovascular Surgery 12(2):82-86, 2010) KEY WORDS : External ventricular drain Lateral ventricle Head computed tomography Introduction Insertion of an external ventricular drain (EVD) is one of the most frequently practiced emergency neurosurgical procedures. Patients requiring EVD placement are usually in critical condition and are managed in an intensive care setting. 17) The universal standard technique of EVD placement is 82
2 Ji-Hoon Lee Cheol-Wan Park Uhn Lee Young-Bo Kim Chan-Jong Yoo Eun-Young Kim, et al free-hand insertion, using surface landmarks to direct the ventricular catheter from a frontal burr hole toward the ipsilateral frontal horn of the lateral ventricle close to the foramen of Monro. 7)9)15) Most published studies have dealt with EVD complications such as infection and hemorrhage, but few have reported on the accuracy of standard techniques for EVD catheter positioning. In this study, the authors analyzed the institutional practice of EVD insertion in terms of the accurate localization of the EVD tip and performed a retrospective study to determine the accuracy of successful EVD placement. Materials and Methods All the EVD insertion procedures performed in our hospital during the study period from January 2007 to December 2009 were retrospectively analyzed. The patients medical records were reviewed via an electronic medical information system. All patients had at least one routine post-evd computed tomographic (CT) head scan, which was reviewed using the hospital PACS system for the accuracy of the EVD tip position. The preoperative Evan s index (the maximal frontal horn ventricular width divided by the transverse inner diameter of the cranium at the same brain scan section) was also measured. EVD tip location was categorized into one of the following six groups: 1) ipsilateral frontal horn of the lateral ventricle, 2) contralateral frontal horn of the lateral ventricle, 3) third ventricle, 4) ipsilateral or contralateral body of the lateral ventricle, 5) basal cistern, or 6) brain parenchyma. The estimated intracranial EVD length was measured on the scout images of the CT scan, measuring from the tip of the EVD to the inner table of the cranium at the burr hole. The standard practice in our institution is to perform all EVD insertion procedures in the operating room with the patient under local anesthesia after routine skin preparation and draping, with the patient s head in a neutral position. About a 3cm skin incision is made over the Kocher s point (2.5cm from midline and 1cm anterior to the coronal suture). A burr hole is made using a high-speed air drill (6mm in diameter), bipolar coagulation occurs, and then a dural opening is created and the stylet-loaded ventricular catheter is introduced, aimed at the medial epicanthus in the coronal plane and just anterior to the external auditory meatus in the sagittal plane. The desired target is the ipsilateral frontal horn of the lateral ventricle close to the foramen of Monro. The catheter is kept in a position that is not to be advanced beyond 6 cm from the brain surface. The used EVD catheter is 35cm in length and 2.8mm in outer diameter, has 3 markings at 5cm intervals, and 4 proximal fenestrations that extend over 2.4cm. Free flow of CSF is considered a sign of successful placement, which is usually followed by subcutaneous tunneling of the distal end of the ventricular catheter before closing the skin and fixing the catheter to avoid inadvertent postoperative pullout. The distal end of the catheter is then attached to a closed drainage bag system and/or intracranial pressure monitor unit. Results A total of 113 patients had emergency free hand EVD insertion procedures during the last 3 years. The mean age of the patients was years (age range, 12~90 years), and there were 58 male and 55 female patients. The most common indication for EVD placement was supratentorial ICH and IVH (57.5%) (Table 1). The EVD was inserted on the right side through Kocher s point in 67 procedures (59.3%), on the left in 34 (30.1%), and bilaterally in 12 (10.6%). The mean preoperative Evan s index was Forty-five of a total of 113 EVDs were placed by less experienced neurosurgical trainees, and the remaining 68 Table 1. Demographic data in 113 patients Variations No. of patients (%) Sex Male 58 (51.3) Female 55 (49.7) Mean age 55.6 ±15.3 years Preoperative diagnosis Supratentorial ICH & IVH 65 (57.5) Infratentorial ICH & IVH 9 (8.0) SAH with IVH or IVH only 27 (23.9) Supratentorial SOL 5 (4.4) Infratentorial SOL 0 (0.0) Others 7 (6.2) * ICH, intracerebral hemorrhage; IVH, intraventricular hemorrhage; SAH, subarachnoid hemorrhage; SOL, spaceoccupying lesion Kor J Cerebrovascular Surgery 12(2):82-86,
3 Accuracy of the Free Hand Placement of an External Ventricular Drain (EVD) were placed by experienced practitioners. A postoperative CT scan was routinely performed in all 113 patients. Of those, 48 EVD tips (42.5%) were in the ipsilateral frontal horn of the lateral ventricle close to the foramen of Monro (considered to be the correct position); 22 (19.5%) were in the third ventricle, 16 (14.1%) in the body of the ipsilateral or contralateral lateral ventricle, 14 (12.4%) in the contralateral frontal horn of the lateral ventricle, 11 (9.7%) within the brain parenchyma, and 2 (1.8%) in the basal cistern (Fig. 1). The mean estimated intracranial EVD length was mm. The mean length of the intracranial EVDs that were positioned in the ipsilateral frontal horn was mm, whereas those in the brain parenchyma and basal cistern were mm and mm, respectively. There was a statistically significant relationship between the EVD tip location (correct or wrong position) and the intracranial EVD length. This result comes out if the intracranial EVD length of 6 cm is set as a reference (p=0.001) (Table 4). When the Evan s index of preoperative CT scans was less than 0.4, 37.2% of the EVD tips were not in the ipsilateral frontal horn of lateral ventricle compared to 20.4% with an Evan s index of more than 0.4 (p=0.180) (Table 2). There was no statistically significant relationship between the surgeon s experience and the accuracy of the position of the EVD tip (p=0.411) (Table 3). Discussion Intraoperatively, neurosurgeons typically and repeatedly measure the success or failure of free hand EVD placement by the free flow of CSF from the distal end of the EVD catheter. Most ventricular catheters have multiple holes along the proximal 2 to 2.5cm, so successful placement of a few of these holes within the CSF space produces at least a brief period of CSF flow intraoperatively, even though the tip might be within the brain parenchyma. This explains our observation that approximately 50% of EVD tips were in CSF spaces other than the desired frontal horn of the lateral ventricle and that almost 10% of the tips were within the brain parenchyma. Our results are not far from the results of previous reports on the same subject. 4)11)12) Table 2. Evan s ratio versus extraventricular drain tip location cross-tabulation Evan s index Tip location Total Ipsilateral FH Other CSF space & parenchyma < (22.1) 42 (37.2) 67 > (20.4) 23 (20.4) 46 Total 48 (42.5) 65 (57.5) 113 Table 3. Surgeon s experience versus extraventricular drain tip location cross-tabulation Tip location Surgeon s experience Total Less experienced Experienced Ipsilataral FH 28 (24.8) 37 (32.7) 65 Other CSF space 17 (15.0) 31 (27.4) 48 & parenchyma Total 45 (39.8) 68 (60.2) 113 Table 4. EVD tip location versus EVD length cross-tabulation Tip location EVD length (cm) Total <6.0 >6.0 Fig. 1. Graph showing the extraventricular drain tip locations and percent occurrences for each location. * FH, frontal horn; Body, body of lateral ventricle Ipsilataral FH 41 (36.3) 7 (6.2) 48 Other CSF space 35 (31.0) 30 (26.5) 65 & parenchyma Total 76 (67.3) 37 (32.7) Kor J Cerebrovascular Surgery 12(2):82-86, 2010
4 Ji-Hoon Lee Cheol-Wan Park Uhn Lee Young-Bo Kim Chan-Jong Yoo Eun-Young Kim, et al Huyette et al. 11) studied the accuracy of freehand ventriculostomy in 97 patients. In Huyette et al. s study, 56.1% of EVD catheter tips were in the ipsilateral lateral ventricle, 7.1% in the contralateral lateral ventricle, 8.2% in the third ventricle, 6.1% within the interhemispheric fissure, and 22.4% within extraventricular spaces. Khanna et al. 12) retrospectively compared the accuracy of practice for EVDs with parenchymal intracranial pressure (ICP) monitors. The rate of misplaced EVDs was 20% (21 out of 104) and included the EVD catheter tips that were placed in the third ventricle, thalamus, brainstem, and other areas. Bogdahn et al. 4) reported an 11% rate of misplaced EVDs that had to be replaced. In a study on the surgical management of EVD placement using a virtual reality simulator, 57 (73%) of 78 catheter tips successfully reached the ventricle, and the remaining 21 out of 78 attempts (27%) were unsuccessful. Among the successful attempts, 22 (38.5%) reached the anterior horn of the ipsilateral lateral ventricle, whereas 48 of 113 (42.5%) EVD tips were in the frontal horn in this current study. In addition, the study using the virtual reality simulator found that there was no statistically significant correlation between the number of neurosurgical training years of the surgeon and the performance 3), which was also found in the present study. Many techniques have been used in the past to improve the success rate and accuracy of ventricular catheter placement. Percutaneous CT controlled ventriculostomy has improved the accuracy of EVD placement and reduced the number of required EVD catheter passes as well as allowed the use of a twist drill hole as opposed to burr hole. 13)18) HS Min and JH Song 10) reported on the accuracy of placement of a parieto-occipital ventricular catheter using CT parameters during a ventriculoperitoneal shunt (VPS) procedure. In Min and Song s study, of 20 patients undergoing VPS insertion using this technique, none had poor location of the proximal ventricular catheter. In the counterpart (non-ct guided group), 9 out of 20 patients had poor location (p=0.001). The Ghajar Guide (Neurodynamics Inc., New York, NY, USA) is a device that sits on the calvarial surface and guides the ventriculostomy perpendicular to the plane tangent to the calvarium at the burr hole. It is useful only when the patient s brain anatomy has not been distorted by a mass lesion. In a prospective trial assessing EVD placement accuracy using the Ghajar Guide, the average distance from the ventriculostomy catheter tip to the foramen of Monro was mm using the guide and mm without the guide 16). Comparing the results of the free hand group in this study to those of the study of Huyette et al. in terms of the success rate of placing the EVD catheter tip in the ipsilateral lateral ventricle (96.0% versus 56.1%) raises the question of whether placement accuracy is related to the competitive nature of a prospective and retrospective study or to the emphasis on keeping a 5.5cm of intracranial EVD length. 11) In a study of image-guided robotic placement of 16 ventricular catheters, successful placement with a single pass was reported with no intraparenchymal catheter tip placement. The mean distance of the catheter tip from the target was mm. Furthermore, 9 of 16 patients (56%) had a ventricular diameter of 5mm of less. 14) A potential advantage of image-guided methods is one-pass catheter placement, which may decrease procedural time, especially when the patient s anatomy is grossly distorted and the superficial anatomical landmarks are rendered useless. On the contrary, the disadvantages of image-guided techniques are that they are considerably more expensive, require equipment that may be awkward to use or bulky, and have a limited capability for real-time upgrading of the images. 11) Other proposed methods to improve the accuracy of ventricular catheter placement include the use of a localizer device or endoscope, 2) and stylet guidance using ultrasonography. 8) In addition, training simulation has been used in neurosurgery education and can be applied to ventriculostomy training to improve the performance of the procedure. 3)6) This study has several limitations common to retrospective studies. We did not investigate in any case whether there was a revision due to the wrong placement of an EVD, the outcome and its relation to the malposition of the EVD tips. We also did not count and analyze the number of passes of the EVD catheter needed for successful CSF drainage; this number, can be related to outcome. Conclusion The results of the present analysis show that there was a statistically significant relationship between the EVD tip location and intracranial EVD length. On the other hand, there was no statistical significance between the tip location Kor J Cerebrovascular Surgery 12(2):82-86,
5 Accuracy of the Free Hand Placement of an External Ventricular Drain (EVD) and Evan s index, as well as between the tip location and surgeon s experience. Many neurosurgeons may feel that the current practice of EVD placement is adequate. However, we consider that emergency free-hand insertion of an EVD may be an inaccurate procedure. The results of this study show that there is much room for improvement. Further multi-institutional prospective study is required to assess the accuracy and complications of free hand placement of an EVD, as well as the feasibility of routine use of intra operative neuro-navigation using other guidance tools, such as an ultrasonography. REFERENCES 1) Arabi Y, Memish ZA, Balkhy HH, Francis C, Ferayan A, Al Shimemeri A, et al. Ventriculostomy-associated infection: Incidence and risk factors. Am J Infect Control 33: , ) Arginteanu M, Abbott R, Frempong A. ISG viewing wandguided endoscopic catheter placement for treatment of posterior fossa CSF collection. Pediatr Neurosurg 27: , ) Banerjee PP, Luciano CJ, Lemole GM Jr, Charbel FT, Oh MY. Accuracy of ventriculostomy catheter placement using a headand hand-tracked high-resolution virtual reality simulator with haptic feedback. J Neurosurg 107: ,2007 4) Bogdahn U, Lau W, Hassel W, Gunreben G, Mertens HG, Brawanski A. Continuous-pressure controlled, external ventricular drainage for treatment of acute hydrocephalus: Evaluation of risk factors. Neurosurgery 31: ,1992 5) Bota DP, Lefranc F, Vilallobos HR, Brilmioulle S, Vincent JL. Ventriculostomy related infections in critically ill patients: A 6- year experience. J Neurosurg 103: , ) Garell PC, Mirsky R, Noh MD, Loftus CM, Hitchon PW, Grady MS, et al. Posterior ventricular catheter burr-hole localizer. Technical note. J Neurosurg 89: ,1998 7) Ghajar JB. A guide for ventricular catheter placement. Technical note. J Neurosurg 63: ,1985 8) Gomez CR. Ultrasonic ventriculostomy stylet. Neurosurgery 37: , ) Greenberg MS. Operation and procedures in Handbook of Neurosurgery. ed 6, New York, Thieme Co., 2006, pp ) HS Min, JH Song. Accurate placement of parieto-occipital ventricular catheter using CT parameters. J Korean Neurosug Soc 29: , ) Huyette DR, Turnbow BJ, Kaufman C, Vaslow DF, Whiting BB, Oh MY. Accuracy of the freehand pass technique for ventriculostomy catheter placement: Retrospective assessment using computed tomography scans. J Neurosurg 108:88-91, ) Khanna RK, Rosenblum ML, Rock JP, Malik GM. Prolonged external ventricular drainage with percutaneous long-tunnel ventriculostomies. J Neurosurg 83: , ) Krotz M, Linsenmaier U, Kanz KG, Pfeifer KJ, Mutschler W, Reiser M. Evaluation of minimally invasive percutaneous CT controlled ventriculostomy in patients with severe head trauma. Eur Radiol 14: , ) Lollis SS, Roberts DW. Robotic catheter ventriculostomy. Feasibility, efficacy, and implication. J Neurosurg 108: , ) Mapstone TB, Ratcheson RA. Techniques of ventricular puncture, in Wilkins RH, Rengachary SS: Neurosurgery. New York, McGraw-Hill, Inc., 1996, vol 1, pp ) O Leary AP, Kole MK, Hoover DA, Hysell SE, Thomas A, Shaffrey CI. Efficacy of the Ghajar Guide revisited: A prospective study. J Neurosurg 92: , ) Roitberg BZ, Khan N, Alp MS, Hersonskey T, Charbel FT, Ausman JI. Bedside external ventricular drain placement for the treatment of acute hydrocephalus. Br J Neurosurg 15: , ) Ruchholtz S, Waydhas C, Muller A, Lewan UM, Nast-Kolb D, Euler E, et al. Percutaneous computed tomographic-controlled ventriculostomy in severe traumatic brain injury. J Trauma 45: , Kor J Cerebrovascular Surgery 12(2):82-86, 2010
The misplacement of external ventricular drain by freehand method in emergent neurosurgery
Acta Neurol. Belg., 2011, 111, 22-28 Original articles The misplacement of external ventricular drain by freehand method in emergent neurosurgery Cheng-Ta HsieH 1,2, Guann-Juh CHen 1, Hsin-i Ma 1, Cheng-Fu
More informationAccuracy and Safety of Bedside External Ventricular Drain Placement at Two Different Cranial Sites : Kocher s Point versus Forehead
online ML Comm www.jkns.or.kr http://dx.doi.org/10.3340/jkns.2011.50.4.317 J Korean Neurosurg Soc 50 : 317-321, 2011 Print ISSN 2005-3711 On-line ISSN 1598-7876 Copyright 2011 The Korean Neurosurgical
More informationAccurate placement of a ventricular catheter is crucial
clinical article J Neurosurg 124:1429 1433, 2016 Calvarial slope affecting accuracy of Ghajar Guide technique for ventricular catheter placement Jaechan Park, MD, PhD, 1,2 Wonsoo Son, MD, 1,2 Ki-Su Park,
More informationExternal Ventricular Drainage & Lumbar Drainage Procedure and Care. Amey R. Savardekar Assistant Professor Neurosurgery, NIMHANS.
External Ventricular Drainage & Lumbar Drainage Procedure and Care. Amey R. Savardekar Assistant Professor Neurosurgery, NIMHANS. External Ventricular Drain Indications: Therapeutic (To relieve raised
More informationExternal ventricular drain (EVD) placement for cerebrospinal. FOCUS Neurosurg Focus 43 (5):E5, 2017
NEUROSURGICAL FOCUS Neurosurg Focus 43 (5):E5, 2017 Real-time ultrasound-guided external ventricular drain placement: technical note James H. Manfield, MBBS, MSc, MRCS, 1 and Kenny K. H. Yu, MBBS, MRCS,
More informationFreehand insertion of external ventricular drains
CLINICAL ARTICLE Utilizing preprocedural CT scans to identify patients at risk for suboptimal external ventricular drain placement with the freehand insertion technique Mitchell P. Wilson, MD, 1 Cian O
More informationDo Iatrogenic Factors Bias the Placement of External Ventricular Catheters? A Single Institute Experience and Review of the Literature
Neurol Med Chir (Tokyo) 5, 8 86, Do Iatrogenic Factors Bias the Placement of External Ventricular Catheters? A Single Institute Experience and Review of the Literature Christoph M. WOERNLE, Jan-Karl BURKHARDT,
More informationEffect of Electromagnetic Navigated Ventriculoperitoneal Shunt Placement on Failure Rates
www.jkns.or.kr http://dx.doi.org/10.3340/jkns.2013.53.3.150 J Korean Neurosurg Soc 53 : 150-154, 2013 Print ISSN 2005-3711 On-line ISSN 1598-7876 Copyright 2013 The Korean Neurosurgical Society Clinical
More informationAn approach using the occipital parietal point for placement of ventriculoperitoneal catheters in adults. Abstract Introduction Methods Results
An approach using the occipital parietal point for placement of ventriculoperitoneal catheters in adults. Jason Duong, DO 1, Dan Miulli DO 1, Fanglong Dong, PhD 2, Andrew Sumida MSIV 3, 1 Neurosurgery
More informationPerioperative Management Of Extra-Ventricular Drains (EVD)
Perioperative Management Of Extra-Ventricular Drains (EVD) Dr. Vijay Tarnal MBBS, FRCA Clinical Assistant Professor Division of Neuroanesthesiology Division of Head & Neck Anesthesiology Michigan Medicine
More informationMultiple Intracranial High Density Foci after Brain Parenchymal Catheterization
CLINICL RTICLE Korean J Neurotrauma 2016;12(2):118-122 pissn 2234-8999 / eissn 2288-2243 https://doi.org/10.13004/kjnt.2016.12.2.118 Multiple Intracranial High Density Foci after rain Parenchymal Catheterization
More informationThe use of intracranial pressure (ICP) monitoring in the
Training Protocol for Intracranial Pressure Monitor Placement by Nonneurosurgeons: 5-Year Experience Kathryn Ko, MD, and Alicia Conforti, RN Background: This report evaluates a protocol for training nonneurosurgeon
More informationThe Hydrocephalus Clinical Research Network
J Neurosurg Pediatrics 14:173 178, 2014 AA, 2014 Factors associated with ventricular catheter movement and inaccurate catheter location: post hoc analysis of the Hydrocephalus Clinical Research Network
More informationThe management of ICH when to operate when not to?
The management of ICH when to operate when not to? Intracranial Hemorrhage High Incidence o Accounts for 10-15% of all strokes 1,2,5 o 80,000 cases in US; 2 million WW 2,5 o Incidence doubles for African-
More informationHemorrhage Rates Associated with Two Methods of Ventriculostomy: External Ventricular Drainage vs. Ventriculoperitoneal Shunt Procedure
ORIGINAL ARTICLE Neurol Med Chir (Tokyo) 54, 545 551, 2014 doi: 10.2176/nmc.oa.2013-0178 Online February 10, 2014 Hemorrhage Rates Associated with Two Methods of Ventriculostomy: External Ventricular Drainage
More informationAPP Placement of ICP Monitors. Sanjay Patra, MD
APP Placement of ICP Monitors Sanjay Patra, MD Can midlevel providers place external ventricular drains safely and accurately? Sanjay Patra MD MSc Director Epilepsy Surgery Director Brain Trauma Spectrum
More informationHEAD AND NECK IMAGING. James Chen (MS IV)
HEAD AND NECK IMAGING James Chen (MS IV) Anatomy Course Johns Hopkins School of Medicine Sept. 27, 2011 OBJECTIVES Introduce cross sectional imaging of head and neck Computed tomography (CT) Review head
More informationManual Occipital Ventricular Puncture for Cerebrospinal Fluid Shunt Surgery: Can Aiming Be Standardized?
Neurol Med Chir (Tokyo) 44, 353 358, 2004 Manual Occipital Ventricular Puncture for Cerebrospinal Fluid Shunt Surgery: Can Aiming Be Standardized? Satoru SHIMIZU*, **, RyusuiTANAKA*, HideoIIDA**, and Kiyotaka
More informationRadiological evaluation of ventriculoperitoneal shunt systems
Radiological evaluation of ventriculoperitoneal shunt systems Poster No.: C-702 Congress: ECR 2009 Type: Educational Exhibit Topic: Neuro Authors: T. Rodt, C. von Falck, C. Tschan, M. Diensthuber, J. Zajaczek,
More informationPlacement and revision of ventricular shunts for hydrocephalus
J Neurosurg 120:684 696, 2014 AANS, 2014 Improvement in clinical outcomes following optimal targeting of brain ventricular catheters with intraoperative imaging Clinical article Christopher G. Janson,
More informationCT Fluoroscopy-guided Aspiration of Intracerebral Hematomas: Technique and Outcomes
Journal of Cerebrovascular and Endovascular Neurosurgery pissn 2234-8565, eissn 2287-3139, http://dx.doi.org/10.7461/jcen.2015.17.1.7 Original Article CT Fluoroscopy-guided Aspiration of Intracerebral
More informationThe management of ICH when to operate when not to?
The management of ICH when to operate when not to? ICH is a Bad Disease High Incidence o Accounts for 10-15% of all strokes 1,2,5 o 80,000 cases in US; 2 million WW 2,5 o Incidence doubles for African-
More informationNEURORADIOLOGY DIL part 3
NEURORADIOLOGY DIL part 3 Bleeds and hemorrhages K. Agyem MD, G. Hall MD, D. Palathinkal MD, Alexandre Menard March/April 2015 OVERVIEW Introduction to Neuroimaging - DIL part 1 Basic Brain Anatomy - DIL
More informationResidence of Discipline of Neurosurgery of Hospital da Santa Casa de Misericórdia of Sao Paulo Sao Paulo, Brazil
Cronicon OPEN ACCESS NEUROLOGY Research Article Efficacy of the Lamina Terminalis Fenestration Associated With the Liliequist Membrane Fenestration in Reducing Shunt-Dependent Hydrocephalus Following Aneurysm
More informationGEORGE E. PERRET, M.D., AND CARL J. GRAF, M.D.
J Neurosurg 47:590-595, 1977 Subgaleal shunt for temporary ventricle decompression and subdural drainage GEORGE E. PERRET, M.D., AND CARL J. GRAF, M.D. Division of Neurological Surgery, University of Iowa
More informationResearcher 2018;10(3)
Comparative study between frontal and posterior parietal ventriculo-peritoneal shunts in management of hydrocephalus Prof. Dr. Abdelhalim Moasa, Dr. Mohamed Hasan and Mohamed Abdelrazek Department of Neurosurgery,
More informationStereotactic Burr Hole Aspiration Surgery for Spontaneous Hypertensive Cerebellar Hemorrhage
Journal of Cerebrovascular and Endovascular Neurosurgery ISSN 2234-8565, EISSN 2287-3139, http://dx.doi.org/10.7461/jcen.2012.14.3.170 Original Article Stereotactic Burr Hole Aspiration Surgery for Spontaneous
More informationCerebro-vascular stroke
Cerebro-vascular stroke CT Terminology Hypodense lesion = lesion of lower density than the normal brain tissue Hyperdense lesion = lesion of higher density than normal brain tissue Isodense lesion = lesion
More informationComplex Hydrocephalus
2012 Hydrocephalus Association Conference Washington, DC - June 27-July1, 2012 Complex Hydrocephalus Marion L. Walker, MD Professor of Neurosurgery & Pediatrics Primary Children s Medical Center University
More informationSURGICAL MANAGEMENT OF BRAIN TUMORS
SURGICAL MANAGEMENT OF BRAIN TUMORS LIGIA TATARANU, MD, Ph D NEUROSURGICAL CLINIC, BAGDASAR ARSENI CLINICAL HOSPITAL BUCHAREST, ROMANIA SURGICAL INDICATIONS CONFIRMING HISTOLOGIC DIAGNOSIS REDUCING TUMOR
More informationIntegra B: Camino OLM Intracranial Pressure Monitoring Kit SURGICAL TECHNIQUE
Integra 110-4B: Camino OLM Intracranial Pressure Monitoring Kit SURGICAL TECHNIQUE Surgical Technique Th OLM ICP Kit was developed in cooperation with Richard C. Ostrup, M.D., Thomas G. Luerssen, M.D.
More informationCLEAR III TRIAL : UPDATE ON SURGICAL MATTERS THAT MATTER
CLEAR III TRIAL : UPDATE ON SURGICAL MATTERS THAT MATTER CLEAR Surgical Center Team July 2011 Trial Enrollment Status Updates Insert latest enrollment update chart from most recent CLEAR newsletter Imaging
More informationIoannis N. Mavridis, Athanassios Mitropoulos, Constantinos Mantas, Aikaterini Karagianni, and Konstantinos Vlachos
Hindawi Case Reports in Medicine Volume 2017, Article ID 3953248, 6 pages https://doi.org/10.1155/2017/3953248 Case Report Delayed Intraventricular Hemorrhage following a Ventriculoperitoneal Shunt Placement:
More informationSurgical techniques and procedures for cerebrovascular surgery. Surgery for the AVF at the cranio-cervical junction and high cervical spine
VS-1 Surgery for the AVF at the cranio-cervical junction and high cervical spine Hiroyuki Kinouchi University of Yamanashi, Department of Neurosurgery Dural AVFs have been recognized as common type of
More informationFactors Related to the Development of Shunt-Dependent Hydrocephalus Following Subarachnoid Hemorrhage in the Elderly
DOI: 10.5137/1019-5149.JTN.19752-16.1 Received: 21.12.2016 / Accepted: 19.03.2017 Published Online: 10.05.2017 Turk Neurosurg 28(2):226-233,2018 Original Investigation Factors Related to the Development
More informationPROPOSAL FOR MULTI-INSTITUTIONAL IMPLEMENTATION OF THE BRAIN INJURY GUIDELINES
PROPOSAL FOR MULTI-INSTITUTIONAL IMPLEMENTATION OF THE BRAIN INJURY GUIDELINES INTRODUCTION: Traumatic Brain Injury (TBI) is an important clinical entity in acute care surgery without well-defined guidelines
More informationTraumatic brain Injury- An open eye approach
Traumatic brain Injury- An open eye approach Dr. Sunit Dr Sunit, Apollo children's hospital Blah blah Lots of head injury Lot of ill children Various methods of injury Various mechanisms of brain damage
More informationPedicle screw placement accuracy in thoracic and lumbar spinal surgery with a patient-matched targeting guide: A cadaveric study
Pedicle screw placement accuracy in thoracic and lumbar spinal surgery with a patient-matched targeting guide: A cadaveric study [ based on the homonymous paper from Prof.Lamartina et al. Anticipated publication
More informationInsertion of an external ventricular drain (EVD) is a
Short Communication Intracerebral Hemorrhage With Severe Ventricular Involvement Lumbar Drainage for Communicating Hydrocephalus Hagen B. Huttner, MD; Simon Nagel, MD; Elena Tognoni; Martin Köhrmann, MD;
More informationVentriculo-Peritoneal/ Lumbo-Peritoneal Shunts
Ventriculo-Peritoneal/ Lumbo-Peritoneal Shunts Exceptional healthcare, personally delivered Ventriculo-Peritoneal/ Lumbo-Peritoneal Shunts What is hydrocephalus? Hydrocephalus is the build up of an excess
More informationUltrasound examination of the neonatal brain
Ultrasound examination of the neonatal brain Guideline for the performance and reporting of neonatal and preterm brain ultrasound examination, by the Finnish Perinatology Society and the Paediatric Radiology
More informationSupratentorial cerebral arteriovenous malformations : a clinical analysis
Original article: Supratentorial cerebral arteriovenous malformations : a clinical analysis Dr. Rajneesh Gour 1, Dr. S. N. Ghosh 2, Dr. Sumit Deb 3 1Dept.Of Surgery,Chirayu Medical College & Research Centre,
More informationRisk factors for Ventriculoperitoneal shunting in children with posterior fossa tumor
Risk factors for Ventriculoperitoneal shunting in children with posterior fossa tumor Raed M Aljubour, MD *, Ahmed K Alomari, MD*, Awni F Musharbash, MD** ABSTRACT Objectives: To investigate the Predictors
More informationA Novel Implantable Cerebrospinal Fluid Reservoir : A Pilot Study
Clinical Article J Korean Neurosurg Soc 61 (5) : 640-644, 2018 https://doi.org/10.3340/jkns.2018.0098 pissn 2005-3711 eissn 1598-7876 A Novel Implantable Cerebrospinal Fluid Reservoir : A Pilot Study Yoon
More information(12) United States Patent
(12) United States Patent Ghahremani et al. USOO62O6885B1 (10) Patent No.: US 6,206,885 B1 (45) Date of Patent: Mar. 27, 2001 (54) (76) (*) (21) (22) (60) (51) (52) (58) (56) CATHETER GUIDE AND DRILL GUIDE
More informationMeninges and Ventricles
Meninges and Ventricles Irene Yu, class of 2019 LEARNING OBJECTIVES Describe the meningeal layers, the dural infolds, and the spaces they create. Name the contents of the subarachnoid space. Describe the
More informationVentriculostomy and Risk of Upward Herniation in Patients with Obstructive Hydrocephalus from Posterior Fossa Mass Lesions
https://doi.org/10.1007/s12028-017-0487-3 ORIGINAL ARTICLE Ventriculostomy and Risk of Upward Herniation in Patients with Obstructive Hydrocephalus from Posterior Fossa Mass Lesions Sherri A. Braksick
More informationHead CT Scan Interpretation: A Five-Step Approach to Seeing Inside the Head Lawrence B. Stack, MD
Head CT Scan Interpretation: A Five-Step Approach to Seeing Inside the Head Lawrence B. Stack, MD Five Step Approach 1. Adequate study 2. Bone windows 3. Ventricles 4. Quadrigeminal cistern 5. Parenchyma
More informationA Less Invasive Approach for Ruptured Aneurysm with Intracranial Hematoma: Coil Embolization Followed by Clot Evacuation
A Less Invasive Approach for Ruptured Aneurysm with Intracranial Hematoma: Coil Embolization Followed by Clot Evacuation Je Hoon Jeong, MD 1 Jun Seok Koh, MD 1 Eui Jong Kim, MD 2 Index terms: Endovascular
More informationTyler Carson D.O., Vladamir Cortez D.O., Dan E. Miulli D.O.
Bedside Intracranial Hematoma Evacuation and Intraparenchymal Drain Placement for Spontaneous Intracranial Hematoma Larger than 30 cc in Volume: Institutional Experience and Patient Outcomes Tyler Carson
More informationExtent of subarachnoid hemorrhage and development of hydrocephalus
Clinical Science Extent of subarachnoid hemorrhage and development of hydrocephalus Mirsad Hodžić, Mirza Moranjkić, Zlatko Ercegović, Harun Brkić Department of neurosurgery, University Clinical Center
More informationNeurosurgical Techniques
Neurosurgical Techniques EBEN ALEXANDER, JR., M.D., EDITOR Supratentorial Skull Flaps GuY L. ODOM, M.D., AND BARNES WOODHALL,!V[.D. Department of Surgery, Division of Neurosurgery, Duke University Medical
More informationThe "Keyhole": A Sign of
473 The "Keyhole": A Sign of Herniation of a Trapped Fourth Ventricle and Other Posterior Fossa Cysts Barbara J. Wolfson' Eric N. Faerber' Raymond C. Truex, Jr. 2 When a cystic structure in the posterior
More informationCranial Postoperative Site: MR Imaging Appearance
27 Cranial Postoperative Site: MR Imaging Appearance Charles F. Lanzieri1 Mark Larkins2 Andrew Mancall 1 Ronald Lorig 1 Paul M. Duchesneau 1 Scott A. Rosenbloom 1 Meredith A. Weinstein 1 The ability to
More informationAlthough neuroendoscopy was originally devised. Small-ventricle neuroendoscopy for pediatric brain tumor management.
J Neurosurg Pediatrics 7:000 000, 7:104 110, 2011 Small-ventricle neuroendoscopy for pediatric brain tumor management Clinical article Robert P. Naftel, M.D., 1 Chevis N. Shannon, M.B.A., M.P.H., Dr.P.H.,
More informationSlide 1. Slide 2. Slide 3. Tomography vs Topography. Computed Tomography (CT): A simplified Topographical review of the Brain. Learning Objective
Slide 1 Computed Tomography (CT): A simplified Topographical review of the Brain Jon Wheiler, ACNP-BC Slide 2 Tomography vs Topography Tomography: A technique for displaying a representation of a cross
More informationComplications of intracranial pressure monitoring in children with head trauma
J Neurosurg (Pediatrics 2) 101:53 58, 2004 Complications of intracranial pressure monitoring in children with head trauma RICHARD C. E. ANDERSON, M.D., PETER KAN, M.D., PAUL KLIMO, M.D., M.P.H., DOUGLAS
More informationOne vs. Two Burr Hole Craniostomy in Surgical Treatment of Chronic Subdural Hematoma
online ML Comm www.jkns.or.kr 10.3340/jkns.2009.46.2.87 J Korean Neurosurg Soc 46 : 87-92, 2009 Print ISSN 2005-3711 On-line ISSN 1598-7876 Copyright 2009 The Korean Neurosurgical Society Clinical Article
More informationQuick practical guide to Cranial Ultrasound in the newborn
Quick practical guide to Cranial Ultrasound in the newborn Introduction A standard set of views is taken to assist with consistent visualisation of structures and in the interpretation of possible abnormalities.
More informationINTRACRANIAL PRESSURE -!!
INTRACRANIAL PRESSURE - Significance raised ICP main cause of death in severe head injury main cause of morbidity in moderate and mild head injury main target and prognostic indicator in the ITU setting
More informationHIROSHI NAKAGUCHI, M.D., PH.D., TAKEO TANISHIMA, M.D., PH.D., Clinical Material and Methods
J Neurosurg 93:791 795, 2000 Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma after burr-hole irrigation and closed-system drainage HIROSHI NAKAGUCHI,
More informationOriginal Article. Emergency Department Evaluation of Ventricular Shunt Malfunction. Is the Shunt Series Really Necessary? Raymond Pitetti, MD, MPH
Original Article Emergency Department Evaluation of Ventricular Shunt Malfunction Is the Shunt Series Really Necessary? Raymond Pitetti, MD, MPH Objective: The malfunction of a ventricular shunt is one
More informationEnhancement of Cranial US: Utility of Supplementary Acoustic Windows and Doppler Harriet J. Paltiel, MD
Enhancement of Cranial US: Utility of Supplementary Acoustic Windows and Doppler Harriet J. Paltiel, MD Boston Children s Hospital Harvard Medical School None Disclosures Conventional US Anterior fontanelle
More informationThe Risk Factors of External Ventricular Drainage-Related Infection at Hospital Kuala Lumpur: An Observational Study
Original Article The Risk Factors of External Ventricular Drainage-Related Infection at Hospital Kuala Lumpur: An Observational Study Mohamad Azhari Omar 1, Mohd Saffari Mohd Haspani 2 Submitted: 4 Aug
More informationMoron General Hospital Ciego de Avila Cuba. Department of Neurological Surgery
Moron General Hospital Ciego de Avila Cuba Department of Neurological Surgery Early decompressive craniectomy in severe head injury with intracranial hypertension Angel J. Lacerda MD PhD, Daisy Abreu MD,
More informationEndovascular Tx Is Safe Alternative When IV tpa Is Contraindicated
Endovascular Tx Is Safe Alternative When IV tpa Is Contraindicated Safety, Effectiveness, and Practicality of Endovascular Therapy Within the First 3 Hours of Acute Ischemic Stroke Onset. Mathews MS, Sharma
More informationThe role of endoscopic third ventriculostomy in the treatment of hydrocephalus
BRIEF COMMUNICATIONS ALBANIAN MEDICAL JOURNAL The role of endoscopic third ventriculostomy in the treatment of hydrocephalus Artur Xhumari 1,2, Ermira Pajaj 2, Maren Ruka 2, Mithat Demneri 2, Mentor Petrela
More informationSOP: Cerebral Ultrasound
SOP: Cerebral Ultrasound Version Author(s) Date Changes Approved by 1.0 Cornelia Hagmann Manon Benders 29.5.2012 Initial Version Gorm Greisen 1.1 Cornelia Hagmann 18.6.2012 Minor changes Gorm Greisen 1.2
More informationMultifocal intraparenchymal hemorrhages after ventriculoperitoneal shunt surgery in infants
J Neurosurg Pediatrics 14:329 335, 2014 AANS, 2014 Multifocal intraparenchymal hemorrhages after ventriculoperitoneal shunt surgery in infants Clinical article Jung Won Choi, M.D., 1 Seung-Ki Kim, M.D.,
More informationEndoscopic Third Ventriculostomy. Dr Kanwaljeet Garg
Endoscopic Third Ventriculostomy Dr Kanwaljeet Garg Introduction Endoscopic third ventriculostomyis a technique to treat non communicating hydrocephalus. Involves making a hole in the floor of the third
More informationBasal ganglia hemorrhage in a case report following spinal surgery
Berry et al. BMC Neurology (2018) 18:204 https://doi.org/10.1186/s12883-018-1218-x CASE REPORT Open Access Basal ganglia hemorrhage in a case report following spinal surgery Brent Berry 1, Malik Ghannam
More informationRisk Factors of Delayed Intracranial Hemorrhage Following Ventriculoperitoneal Shunt
CLINICAL ARTICLE Korean J Neurotrauma 2018;14(2):112-117 pissn 2234-8999 / eissn 2288-2243 https://doi.org/10.13004/kjnt.2018.14.2.112 Risk Factors of Delayed Intracranial Hemorrhage Following Ventriculoperitoneal
More informationOriginal Article. Abstract. Jason Raj Johnson 3, Zamzuri Idris 1,2, Jafri Malin Abdullah 1,2,
Original Article Prevalence of Shunt Dependency and Clinical Outcome in Patients with Massive Intraventricular Haemorrhage Treated with Endoscopic Washout and External Ventricular Drainage Jason Raj Johnson
More informationKeyhole craniectomy in the surgical management of spontaneous intracerebral hematoma
Neurology Asia 2007; 12 : 21 27 Keyhole craniectomy in the surgical management of spontaneous intracerebral hematoma S Balaji Pai, RG Varma, JKBC Parthiban, KN Krishna, RM Varma, *R Srinivasa,*PT Acharya,*BP
More informationDelayed Posttraumatic Hydrocephalus Secondary To An Aqueductal Web Treated With Endoscopic Third Ventriculostomy: A Case Report.
ISPUB.COM The Internet Journal of Neurosurgery Volume 8 Number 1 Delayed Posttraumatic Hydrocephalus Secondary To An Aqueductal Web Treated With Endoscopic Third J Roth, S Rodgers, D Harter Citation J
More informationProcedures commonly seen at Vanderbilt Medical Center PACU s: Cervical, thoracic, lumbar, and sacral spine surgeries. Goes to 6N
Procedures commonly seen at Vanderbilt Medical Center PACU s: Cervical, thoracic, lumbar, and sacral spine surgeries Goes to 6N Burr holes and Craniotomies for hemorrhage, tumors, trauma, debulking Goes
More informationVentriculostomy is one of the most common procedures. Revisiting the rules for freehand ventriculostomy: a virtual reality analysis
CLINICAL ARTICLE J Neurosurg 128:1250 1257, 2018 Revisiting the rules for freehand ventriculostomy: a virtual reality analysis Clemens Raabe, 1,2 Jens Fichtner, MD, 2 Jürgen Beck, MD, 2 Jan Gralla, MD,
More informationClinical Study The Value of Programmable Shunt Valves for the Management of Subdural Collections in Patients with Hydrocephalus
The Scientific World Journal Volume 2013, Article ID 461896, 4 pages http://dx.doi.org/10.1155/2013/461896 Clinical Study The Value of Programmable Shunt Valves for the Management of Subdural Collections
More informationCommunicating Hydrocephalus Accompanied by Arachnoid Cyst in Aneurismal Subarachnoid Hemorrhage
Journal of Cerebrovascular and Endovascular Neurosurgery ISSN 2234-8565, EISSN 2287-3139, http://dx.doi.org/10.7461/jcen.2013.15.4.311 Case Report Communicating Hydrocephalus Accompanied by Arachnoid Cyst
More informationVentricular catheter entry site and not catheter tip location predicts shunt survival: a secondary analysis of 3 large pediatric hydrocephalus studies
Clinical article J Neurosurg Pediatr 19:157 167, 2017 Ventricular catheter entry site and not catheter tip location predicts shunt survival: a secondary analysis of 3 large pediatric hydrocephalus studies
More informationCase Log Mapping Update: April 2018 Review Committee for Neurological Surgery
Case Log Mapping Update: April 2018 Review Committee for Neurological Surgery The Review Committee has made the following changes to the CPT code mappings: The following previously untracked CPT codes
More informationScience & Technologies. A CASE OF HYDROCEPHALUS AND DANDY-WALKER SYNDROME IN A CALF Murat ÇALIŞKAN 1, Soner ÇAĞATAY 1, Ömer BEŞALTI 1
A CASE OF HYDROCEPHALUS AND DANDY-WALKER SYNDROME IN A CALF Murat ÇALIŞKAN 1, Soner ÇAĞATAY 1, Ömer BEŞALTI 1 1 Ankara University, Faculty of Veterinary Medicine, Department of Surgery, Ankara-Turkey Abstract
More informationOriginal Article Remote cerebellar hemorrhage after microsurgical clipping of intracranial aneurysms: diagnosis and treatment a review of 13 cases
Int J Clin Exp Med 2016;9(2):3681-3686 www.ijcem.com /ISSN:1940-5901/IJCEM0012155 Original Article Remote cerebellar hemorrhage after microsurgical clipping of intracranial aneurysms: diagnosis and treatment
More informationTwo-Stage Management of Mega Occipito Encephalocele
Two-Stage Management of Mega Occipito Encephalocele CASE REPORT A I Mardzuki*, J Abdullah**, G Ghazaime*, A R Ariff!'*, M Ghazali* *Department of Neurosciences, **Department of Radiology, Hospital Universiti
More informationCSF MANAGEMENT REIMBURSEMENT GUIDE
CSF MANAGEMENT REIMBURSEMENT GUIDE TABLE OF CONTENTS Cerebrospinal Fluid Shunts ICD-10-CM diagnosis Codes...2 ICD-10-PCS Codes...4 Physician and Hospital Outpatient Coding...6 Hospital Inpatient DRG Assignments...7
More informationPichayen Duangthongpon MD*, Chaiwit Thanapaisal MD*, Amnat Kitkhuandee MD*, Kowit Chaiciwamongkol MD**, Vilaiwan Morthong MD**
The Relationships between Asterion, the Transverse-Sigmoid Junction, the Superior Nuchal Line and the Transverse Sinus in Thai Cadavers: Surgical Relevance Pichayen Duangthongpon MD*, Chaiwit Thanapaisal
More informationOriginal Article CT grouping and microsurgical treatment strategies of hypertensive cerebellar hemorrhage
Int J Clin Exp Med 2016;9(8):15921-15927 www.ijcem.com /ISSN:1940-5901/IJCEM0022273 Original Article CT grouping and microsurgical treatment strategies of hypertensive cerebellar hemorrhage Xielin Tang
More informationMicrosurgery for ruptured cerebellar arteriovenous malformations
European Review for Medical and Pharmacological Sciences Microsurgery for ruptured cerebellar arteriovenous malformations S.-F. GONG 1,2, X.-B. WANG 1,3, Y.-Q. LIAO 1,2, T.-P. JIANG 1,2, J.-B. HE 1,2,
More informationExternal ventricular drainage for intraventricular hemorrhage
Romanian Neurosurgery (2018) XXXII 2: 347-354 347 DOI: 10.2478/romneu-2018-0043 External ventricular drainage for intraventricular hemorrhage V.A. Kiran Kumar 1, N.A. Sai Kiran 1, V. Anil Kumar 2, Luis
More informationClinical Article Anatomy of the cerebral ventricular system for endoscopic neurosurgery: a magnetic resonance study
Acta Neurochir (2003) 145: 359 368 DOI 10.1007/s00701-003-0021-6 Clinical Article Anatomy of the cerebral ventricular system for endoscopic neurosurgery: a magnetic resonance study F. Duffner 1, H. Schiffbauer
More informationNature and Science 2017;15(7) Surgical Options for Treatment of Posterior Fossa Tumors with Hydrocephalus
Surgical Options for Treatment of Posterior Fossa Tumors with Hydrocephalus Mohamed Mahmoud Abohashima; Ahmed Mohamed Hasan Salem; Magdy Asaad El-Hawary Neurosurgery department, Faculty of Medicine, Al-azhar
More informationEstimation of Stellate Ganglion Block Injection Point Using the Cricoid Cartilage as Landmark Through X-ray Review
Original Article Korean J Pain 2011 September; Vol. 24, No. 3: 141-145 pissn 2005-9159 eissn 2093-0569 http://dx.doi.org/10.3344/kjp.2011.24.3.141 Estimation of Stellate Ganglion Block Injection Point
More informationPRACTICE GUIDELINE. DEFINITIONS: Mild head injury: Glasgow Coma Scale* (GCS) score Moderate head injury: GCS 9-12 Severe head injury: GCS 3-8
PRACTICE GUIDELINE Effective Date: 9-1-2012 Manual Reference: Deaconess Trauma Services TITLE: TRAUMATIC BRAIN INJURY GUIDELINE OBJECTIVE: To provide practice management guidelines for traumatic brain
More informationThe incidence of CT scan use is drastically on the
J Neurosurg Pediatrics 12:406 410, 2013 AANS, 2013 Low-dose head computed tomography in children: a single institutional experience in pediatric radiation risk reduction Clinical article Ryan P. Morton,
More informationSurgical Neurology International
Surgical Neurology International OPEN ACCESS For entire Editorial Board visit : http://www.surgicalneurologyint.com Editor: James I. Ausman, MD, PhD University of California, Los Angeles, CA, USA Original
More informationAnesthetic Management of Laparoscopic Surgery for a Patient with
Anesthetic Management of Laparoscopic Surgery for a Patient with a Ventriculoperitoneal shunt Abstract With the advances in the management of hydrocephalus, patients with ventriculoperitoneal shunt are
More informationBrain Meninges, Ventricles and CSF
Brain Meninges, Ventricles and CSF Lecture Objectives Describe the arrangement of the meninges and their relationship to brain and spinal cord. Explain the occurrence of epidural, subdural and subarachnoid
More informationEfficacy of neuroendoscopic evacuation of traumatic intracerebral or intracerebellar hematoma
Original Contribution Kitasato Med J 2017; 47: 141-147 Efficacy of neuroendoscopic evacuation of traumatic intracerebral or intracerebellar hematoma Hiroyuki Koizumi, 1,2 Daisuke Yamamoto, 1 Yasushi Asari,
More informationLumbar Catheter for Monitoring of Intracranial Pressure in Patients with Post-Hemorrhagic Communicating Hydrocephalus
DOI 1.17/s1228-1-949-6 ORIGINAL ARTICLE Lumbar Catheter for Monitoring of Intracranial Pressure in Patients with Post-Hemorrhagic Communicating Hydrocephalus Verena Speck Dimitre Staykov Hagen B. Huttner
More information"Ultrasound measurements of the lateral ventricles in neonates: A comparison of multiple measurements methods."
"Ultrasound measurements of the lateral ventricles in neonates: A comparison of multiple measurements methods." Poster No.: C-1557 Congress: ECR 2014 Type: Authors: Keywords: DOI: Educational Exhibit I.
More information