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Accuracy and Safety of Bedside External Ventricular Drain Placement at Two Different Cranial Sites : Kocher’s Point versus Forehead

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Affiliated Author(s)
김엘
Alternative Author(s)
Kim, El
Journal Title
Journal of Korean Neurosurgical Society
ISSN
2005-3711
Issued Date
2011
Abstract
Objective : External ventricular drain (EVD) is commonly performed with a freehand technique using surface anatomical landmarks at two different cranial sites, Kocher’s point and the forehead. The aim of this study was to evaluate and compare the accuracy and safety of these percutaneous ventriculostomies.
Methods : A retrospectively review of medical records and head computed tomography scans were examined in 227 patients who underwent 250 freehand pass ventriculostomy catheter placements using two different methods at two institutions, between 2003 and 2009. Eighty-one patients underwent 101 ventriculostomies using Kocher’s point (group 1), whereas 146 patients underwent 149 forehead ventriculostomies (group 2).
Results : In group 1, the catheter tip was optimally placed in either the ipsilateral frontal horn or the third ventricle, through the foramen of Monro (grade 1) in 82 (81.1%) procedures, in the contralateral lateral ventricle (grade 2) in 4 (3.9%), and into eloquent structures or non-target cerebrospinal space (grade 3) in 15 (14.8%). Intracerebral hemorrhage (ICH) >1 mL developed in 5 (5.0%) procedures. Significantly higher incidences of optimal catheter placements were observed in group 2. ICH>1 mL developed in 11 (7.4 %) procedures in group 2, showing no significant difference between groups. In addition, the mean interval from the EVD to ventriculoperitoneal shunt was shorter in group 2 than in group 1, and the incidence of EVD-related infection was decreased in group 2.
Conclusion : Accurate and safe ventriculostomies were achieved using both cranial sites, Kocher’s point and the forehead. However, the forehead ventriculostomies provided more accurate ventricular punctures.
Department
Dept. of Neurosurgery (신경외과학)
Publisher
School of Medicine
Citation
Young-Gil Park et al. (2011). Accuracy and Safety of Bedside External Ventricular Drain Placement at Two Different Cranial Sites : Kocher’s Point versus Forehead. Journal of Korean Neurosurgical Society, 50(4), 317–321. doi: 10.3340/jkns.2011.50.4.317
Type
Article
ISSN
2005-3711
DOI
10.3340/jkns.2011.50.4.317
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/39371
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
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