المؤلفون: Chau, Charlene YC, Craven, Claudia L, Rubiano, Andres M, Adams, Hadie, Tülü, Selma, Czosnyka, Marek, Servadei, Franco, Ercole, Ari, Hutchinson, Peter J, Kolias, Angelos G

مصطلحات موضوعية: EVD, ICP, TBI, intracranial pressure, neurosurgery, neurotrauma, ventriculostomy

الوصف: External ventricular drains (EVDs) are commonly used in neurosurgery in different conditions but frequently in the management of traumatic brain injury (TBI) to monitor and/or control intracranial pressure (ICP) by diverting cerebrospinal fluid (CSF). Their clinical effectiveness, when used as a therapeutic ICP-lowering procedure in contemporary practice, remains unclear. No consensus has been reached regarding the drainage strategy and optimal timing of insertion. We review the literature on EVDs in the setting of TBI, discussing its clinical indications, surgical technique, complications, clinical outcomes, and economic considerations.

وصف الملف: Electronic; application/pdf

العلاقة: https://www.repository.cam.ac.uk/handle/1810/296746Test

الإتاحة: https://doi.org/10.17863/CAM.43789Test
https://www.repository.cam.ac.uk/handle/1810/296746Test

المؤلفون: Cabrilo, Ivan¹ (AUTHOR) iv.cabrilo@gmail.com, Craven, Claudia L.¹ (AUTHOR), Dasgupta, Debayan¹ (AUTHOR), Reddy, Ugan² (AUTHOR), Toma, Ahmed K.¹ (AUTHOR)

المصدر: Acta Neurochirurgica. Apr2021, Vol. 163 Issue 4, p1121-1126. 6p.

مصطلحات موضوعية: *NEUROSURGEONS, *CATHETERS, *RETROSPECTIVE studies, *CARDIAC pacing

مستخلص: Objective: The accuracy of tunneled external ventricular drain (EVD) placement has been shown to be similar among practitioners of varying experience, but this has not yet been investigated for bolt EVDs. Tunneled and bolt EVDs are distinct techniques, and it is unclear if conclusions regarding accuracy can be inferred from one method to the other. The goal of this study was to determine whether neurosurgical experience influences the accuracy of bolt EVD placement. Methods: We performed a single-center retrospective analysis of accuracy of bolt EVD placement between 1st December 2018 and 31st May 2020, comparing the accuracy outcomes between three levels of training (junior trainees (JT); mid-grade trainees (MT); senior trainees/fellows (ST)). Accuracy was determined radiologically by two methods: Kakarla grade and by measuring the distance of the catheter tip to its optimal position (DTOP) at the foramen of Monro. Results: Eighty-seven patients underwent insertion of bolt EVDs, of which n = 19 by JT, n = 40 by MT and n = 28 by ST, with a significant difference found between training grades in the median Kakarla grade (p = 0.0055) and in the accuracy of placement as per DTOP (p = 0.0168). Conclusions: In contrast to previous published results on tunneled EVDs, we demonstrate that the accuracy of bolt EVD placement is dependent on neurosurgical experience. Our results draw awareness to the fact that the bolt EVD technique can represent a challenge for less experienced practitioners and underline the importance of dedicated training to support the safe insertion of bolt ventricular catheters. [ABSTRACT FROM AUTHOR]

المؤلفون: Cabrilo, Ivan¹ (AUTHOR) iv.cabrilo@gmail.com, Craven, Claudia L.¹ (AUTHOR), Abuhusain, Hazem¹ (AUTHOR), Pradini-Santos, Laura¹ (AUTHOR), Asif, Hasan¹ (AUTHOR), Marcus, Hani J.¹ (AUTHOR), Reddy, Ugan² (AUTHOR), Watkins, Laurence D.¹ (AUTHOR), Toma, Ahmed K.¹ (AUTHOR)

المصدر: Acta Neurochirurgica. Apr2021, Vol. 163 Issue 4, p1127-1133. 7p.

مصطلحات موضوعية: *CRITICAL care medicine, *INTENSIVE care units, *ANATOMICAL planes, *CEREBROSPINAL fluid, *FLUOROSCOPY

مستخلص: Background: The insertion of bolt external ventricular drains (EVD) on the intensive care unit (ICU) has enabled rapid cranial cerebrospinal fluid (CSF) diversion. However, bolt EVDs tend to be perceived as a more challenging technique, particularly when dealing with small ventricles or when there is midline shift distorting the ventricular morphology. Furthermore, if neuronavigation guidance is felt to be necessary, this usually assumes a transfer to an operating theatre. In this technical note, we describe the use of electromagnetic neuronavigation for bolt EVD insertion on the ICU and assess the protocol's feasibility and accuracy. Methods: Case series of neuronavigation-assisted bolt EVD insertion in ICU setting, using Medtronic Flat Emitter for StealthStation EM. Results: Neuronavigation-guided bolt EVDs were placed at the bedside in n = 5 patients on ICU. Their widest frontal ventricular horn diameter in the coronal plane ranged from 11 to 20 mm. No procedural complications were encountered. Post-procedural CT confirmed the optimal placement of the EVDs. Conclusions: Electromagnetic neuronavigation is feasible at the ICU bedside and can assist the insertion of bolt EVDs in this setting. The preference for a bolt EVD to be inserted in ICU—as is standard practice at this unit—should not prohibit patients from benefitting from image guidance if required. [ABSTRACT FROM AUTHOR]

المؤلفون: Chau, Charlene Y. C.¹ (AUTHOR), Craven, Claudia L.² (AUTHOR), Rubiano, Andres M.^3,4 (AUTHOR), Adams, Hadie¹ (AUTHOR), Tülü, Selma^1,5 (AUTHOR), Czosnyka, Marek¹ (AUTHOR), Servadei, Franco⁶ (AUTHOR), Ercole, Ari⁷ (AUTHOR), Hutchinson, Peter J.^1,4 (AUTHOR), Kolias, Angelos G.^1,4 (AUTHOR) angeloskolias@gmail.com

المصدر: Journal of Clinical Medicine. Sep2019, Vol. 8 Issue 9, p1422. 1p.

مصطلحات موضوعية: *BRAIN injuries, *DRAINAGE, *INTRACRANIAL pressure, *CLINICAL indications, *CEREBROSPINAL fluid

مستخلص: External ventricular drains (EVDs) are commonly used in neurosurgery in different conditions but frequently in the management of traumatic brain injury (TBI) to monitor and/or control intracranial pressure (ICP) by diverting cerebrospinal fluid (CSF). Their clinical effectiveness, when used as a therapeutic ICP-lowering procedure in contemporary practice, remains unclear. No consensus has been reached regarding the drainage strategy and optimal timing of insertion. We review the literature on EVDs in the setting of TBI, discussing its clinical indications, surgical technique, complications, clinical outcomes, and economic considerations. [ABSTRACT FROM AUTHOR]

المؤلفون: Chau, Charlene YC, Craven, Claudia L, Rubiano, Andres M, Adams, Hadie, Tülü, Selma, Czosnyka, Marek, Servadei, Franco, Ercole, Ari, Hutchinson, Peter J, Kolias, Angelos G

مصطلحات موضوعية: neurotrauma, TBI, intracranial pressure, ICP, neurosurgery, ventriculostomy, EVD, nervous system diseases, 3. Good health

الوصف: External ventricular drains (EVDs) are commonly used in neurosurgery in different conditions but frequently in the management of traumatic brain injury (TBI) to monitor and/or control intracranial pressure (ICP) by diverting cerebrospinal fluid (CSF). Their clinical effectiveness, when used as a therapeutic ICP-lowering procedure in contemporary practice, remains unclear. No consensus has been reached regarding the drainage strategy and optimal timing of insertion. We review the literature on EVDs in the setting of TBI, discussing its clinical indications, surgical technique, complications, clinical outcomes, and economic considerations.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::c62f394c3ca15d849036b31558369e22Test