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An external ventricular drain (EVD), also known as a ventriculostomy or extraventricular drain, is a device used in neurosurgery to treat hydrocephalus and relieve elevated intracranial pressure when the normal flow of cerebrospinal fluid (CSF) inside the brain is obstructed.
A cerebral shunt is a device permanently implanted inside the head and body to drain excess fluid away from the brain. They are commonly used to treat hydrocephalus, the swelling of the brain due to excess buildup of cerebrospinal fluid (CSF).
When catheter drainage is permanent, it is usually referred to as a shunt. There are many catheter-based ventricular shunts that are named for where they terminate, for example, a ventriculoperitoneal shunt terminates in the peritoneal cavity, a ventriculoatrial shunt terminates within the atrium of the heart, etc.
Diagram demonstrating surgical placement of a VP shunt used to manage NPH. For suspected cases of NPH, CSF shunting is the first-line treatment. The most common type used to treat NPH is ventriculoperitoneal (VP) shunts, which drain CSF fluid to the peritoneal cavity. Adjustable valves allow fine-tuning of CSF drainage.
For example, it may be required for a patient with a lumbar–peritoneal shunt, if multiple revisions are required or overdrainage is occurring, to have it replaced with a ventriculo–peritoneal shunt (VP shunt). Shunt revisions are required due to the following complications: Over drainage; Under drainage; Infection; Blockage or obstruction
A common procedure performed in neurosurgery is the placement of ventriculo-peritoneal shunt (VP shunt). In pediatric practice this is often implemented in cases of congenital hydrocephalus. The most common indication for this procedure in adults is normal pressure hydrocephalus (NPH). [45]
Unlike the ventriculoperitoneal shunt, however, a lumbar-peritoneal shunt is usually inserted in between two of the vertebrae in the lumbar and punctures the cerebrospinal fluid sack or lumbar subarachnoid space, it then runs beneath the skin to the peritoneal cavity, where it is eventually drained away by the normal bodily fluid drainage ...
Scalp of a patient with an Ommaya reservoir. Dr. Ommaya handling his reservoir. An Ommaya reservoir is an intraventricular catheter system that can be used for the aspiration of cerebrospinal fluid or for the delivery of drugs (e.g. chemotherapy) into the cerebrospinal fluid.