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How to Place an External Ventriculostomy Catheter
(aka: External Ventricular Drain or "Ventric")

Introduction || The Supplies || The Steps || Overview || Related Articles ||
References and Resources || Leave a Comment || Search

Introduction and Indications

An external ventricular drain (EVD) is a catheter that is passed into the lateral ventricles of the brain. It is most commonly placed "at the bedside" by a trained neurosurgeon through a small burr hole drilled into the skull.

Once placed, the EVD provides real time information about intracranial pressure, and perhaps more importantly, can be used to relieve abnormal pressure via the drainage of cerebrospinal fluid.

Common indications for the placement of an external ventricular drain include subarachnoid hemorrhage after aneurysm rupture, traumatic brain injury, and hydrocephalus. Once an EVD is placed, the patient is monitored in an intensive care unit.


The Supplies


The Steps

These steps may not be done in this exact order, and quite frankly, some steps may be completely ignored, altered, or changed depending on the circumstance. This is meant to serve only as a guide to the placement of an EVD.



Ventriculostomy catheters (aka: external ventricular drains or "ventrics") provide real time information about intracranial pressure. They also provide a way to treat elevated intracranial pressure. Common indications for EVD placement include subarachnoid hemorrhage, traumatic brain injury, and acute hydrocephalus.


Related Articles

- Monro-Kellie doctrine

- Subarachnoid hemorrhage

- Acute traumatic brain injury


References and Resources

(1) Camacho EF, Boszczowski I, Basso M, et al. Infection rate and risk factors associated with infections related to external ventricular drain. Infection. 2011 Feb;39(1):47-51. Epub 2011 Jan 25.

(2) Sonabend AM, Korenfeld Y, Crisman C, et al. Prevention of Ventriculostomy-Related Infections with Prophylactic Antibiotics and Antibiotic-Coated External Ventricular Drains: A Systematic Review. Neurosurgery. 2011 Jan 6. [Epub ahead of print]

(3) Gigante P, Hwang BY, Appelboom G, et al. External ventricular drainage following aneurysmal subarachnoid haemorrhage. Br J Neurosurg. 2010 Dec;24(6):625-32. Epub 2010 Sep 20.

(4) Li LM, Timofeev I, Czosnyka M, et al. Review article: the surgical approach to the management of increased intracranial pressure after traumatic brain injury. Anesth Analg. 2010 Sep;111(3):736-48. Epub 2010 Aug 4.

(5) Sankhyan N, Vykunta Raju KN, Sharma S, et al. Management of raised intracranial pressure. Indian J Pediatr. 2010 Dec;77(12):1409-16. Epub 2010 Sep 7.

(6) Frontera JA. Decision Making in Neurocritical Care. First Edition. New York: Thieme, 2009.


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