Instrumentation

Most common insertion sites of ventricular catheters
- 1. occipital-parietal region - CSF Shunt
- 2. keen's point - posterior parietal - placement in trigone
- 3. Dandy's point - may damage visual pathway
- 4. Kochers point - coronal - ICP monitors - placement in frontal horn
Ventriculostomy is also known as
- intraventricular catheter (IVC)
- external ventricular drainage (EVD)
Ventriculostomy insertion
1. preferred side of insertion

1. right or non-dominant side
Ventriculostomy set up
- Clip hair at planed incision site
- Five minute betadine prep
- Approximate Kocher's point
Ventriculostomy approximation of kochers point
- 1 to 2 cm anterior to coronal suture
- 2-3 cm lateral to midline
Ventriculostomy after kochers point has been located and marked
- 1. Incision oriented in sagittal plane
- 2. Elevate periosteum
- 3. Place self retaining retractor
- 4. Make twist drill hole
- 5. Bone wax bone
- 6. Incise dura in cruciate fashion with #11 scalpel blade
- Cauterize dural edges with bipolar
- Insert catheter perpendicular to brain surface to 5 to 7 cm
- CSF will flow at 3 to 4 cm with ventricular enlargement.
- If unsuccessful after 3 attempts place a subarachnoid bolt or intraparenchymal monitor

Author

mbrieger

93487

Card Set

Instrumentation

Description

Instrumentation

Updated

2011-07-10T00:10:57Z

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