Infection Incidence Associated with External Ventriculostomy Placement: A Comparison of Outcomes in the Emergency Department, Intensive Care Unit, and Operating Room

Kohli, Gurkirat; Singh, Roshansa; Herschman, Yehuda; Mammis, Antonios

doi:10.1016/j.wneu.2017.10.129

Cited by 29 publications

(22 citation statements)

References 12 publications

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“…Therefore, in view of the current evidence with its unresolved conclusions, we do not advocate routine bedside EVD in our locality. For catheter placement accuracy, our study supports the observations of larger retrospective reviews that bedside procedures are similar to those performed in the operating theatre …”

Section: Discussionsupporting

confidence: 84%

“…Several studies have confirmed that, when performed by neurosurgeons, bedside EVD haemorrhagic and infectious complications are comparable to those placed in the operating theater . Yet given the high occupancy rates and the close working quarters of Hong Kong neurocritical care units, the occurrence of these complications remains concerning.…”

Section: Discussionmentioning

confidence: 99%

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Bedside external ventricular drain placement for haemorrhagic stroke patients with brain herniation and acute hydrocephalus: A case series

et al. 2018

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Aim: External ventricular drainage (EVD) for patients with acute hydrocephalus is a potentially life-saving neurosurgical procedure that can be quickly performed at the bedside, but is rarely carried out in Hong Kong. Patients and Methods: The present study is a retrospective review of eight adult patients who underwent bedside EVD from 1 January 2010 to 31 March 2018 at Hong Kong's public neurosurgical centres. Disease aetiology, neurological presentation, radiological findings, procedure-related complications and functional outcomes were reviewed. Results: The mean age was 56 years, with a median presenting Glasgow Coma Score of 3/15 with half having at least one fixed dilated pupil. All were treated at a single neurosurgical centre. Five patients had haemorrhagic stroke (63 per cent) with aneurysmal subarachnoid haemorrhage. After bedside EVD, five patients were stable enough to attempt further definitive surgery. All catheters were placed accurately achieving Kakarla grade I, and there were no procedure-related complications. Three patients survived (38 per cent), with one having a mild disability (modified Rankin score of 2) at 1 year after stroke. Conclusion: Our experience indicates that bedside EVD is a feasible life-saving procedure that can be performed in selected rapidly deteriorating haemorrhagic stroke patients with brain herniation in our locality.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Bedside external ventricular drain placement for haemorrhagic stroke patients with brain herniation and acute hydrocephalus: A case series

et al. 2018

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“…An alternative strategy may be a temporary external ventricular drainage (EVD) or an externalized shunt [17]. However, one should keep in mind the relatively high infection and complication rates associated with EVD [20]. In our case, we did not plan the removal of the VP shunt following the aneurysm treatment.…”

Section: Discussionmentioning

confidence: 99%

Acute Obstructive Hydrocephalus due to a Giant Posterior Cerebral Artery Aneurysm in a Pediatric Patient

et al. 2018

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Introduction: Intracranial aneurysms are very rare in children. Although subarachnoidal hemorrhage (SAH) is by far the most common presentation of aneurysms in the majority of the pediatric case series, it is not rare for an unruptured aneurysm to present with a mass effect. Acute hydrocephalus is a common finding following aneurysmal SAH. However, this malady may develop even in the absence of SAH but secondary to direct obstruction by a giant aneurysm. This situation is extremely rare in children, with only a few known case reports in the literature. Case Report: We report the case of a 10-year-old girl who presented with signs and symptoms of acute hydrocephalus; further radiological evaluation revealed obstructive hydrocephalus and a giant posterior cerebral artery aneurysm. Following endovascular treatment of the aneurysm, hydrocephalus was completely resolved, and the patient was symptom free. Conclusion: Although they are very rare, giant intracranial aneurysms must be kept in mind during the differential diagnosis of pediatric acute hydrocephalus cases. Hydrocephalus may resolve spontaneously after the successful treatment of these aneurysms.

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“…External ventricular drain (EVD), otherwise known as external ventriculostomy, is a neurosurgical procedure that is used for monitoring and treatment of elevated intracranial pressure (ICP) after traumatic brain injury (TBI) as well as primary hydrocephalus or secondary to subarachnoid hemorrhage (SAH), intra-parenchymal hemorrhage (IPH), intra-ventricular hemorrhage (IVH), malignancies and cerebrospinal fluid (CSF) leak [1,2]. Although EVD placement is considered a low-risk procedure, it can carry complications such as hemorrhage, obstruction of the drainage system, and the most common EVD-related infections (ERI) [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, the location where an EVD can be placed such as Emergency Room (ER), Operating Room (OR), or the Intensive Care Unite (ICU) have also been proposed as a potential predictor for ERIs [1]. However, these results are still inconsistent, possibly due to the fact that most of these studies have been done in relatively small samples.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Quality Analysis of External Ventricular Drain Infection Rates Following Stroke Diagnoses and Other Brain Injuries: Comparison of Emergency Room and ICU/OR Setting

Altschul¹,

Hamad²,

Kobets³

et al. 2020

Cureus

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Infection Incidence Associated with External Ventriculostomy Placement: A Comparison of Outcomes in the Emergency Department, Intensive Care Unit, and Operating Room

Cited by 29 publications

References 12 publications

Bedside external ventricular drain placement for haemorrhagic stroke patients with brain herniation and acute hydrocephalus: A case series

Bedside external ventricular drain placement for haemorrhagic stroke patients with brain herniation and acute hydrocephalus: A case series

Acute Obstructive Hydrocephalus due to a Giant Posterior Cerebral Artery Aneurysm in a Pediatric Patient

A Retrospective Quality Analysis of External Ventricular Drain Infection Rates Following Stroke Diagnoses and Other Brain Injuries: Comparison of Emergency Room and ICU/OR Setting

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