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Keen's point is one of the ventriculostomy sites used in neurosurgery, typically in pediatrics for ventriculoperitoneal shunt placement. Keen's point is located 3 cm superior and 3 cm posterior to the helix of the ear.
Ventriculostomy is a neurosurgical procedure that involves creating a hole (stoma) within a cerebral ventricle for drainage. It is most commonly performed on those with hydrocephalus . [ 1 ] It is done by surgically penetrating the skull , dura mater, and brain such that the ventricular system ventricle of the brain is accessed.
The EVD is leveled to a common reference point that corresponds to the skull base, usually the tragus or external auditory meatus.The EVD is set to drain into a closed, graduated burette at a height corresponding to a particular pressure level, as prescribed by a healthcare professional, usually a neurosurgeon or neurointensivist.
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
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Endoscopic third ventriculostomy (ETV) is a surgical procedure for treatment of hydrocephalus in which an opening is created in the floor of the third ventricle using an endoscope placed within the ventricular system through a burr hole.
Following the bidirectional Glenn shunt, failure of the procedure can be broadly categorized as failure of procedure, cardiac dysfunction related to surgery, or cardiac dysfunction leading to death before further surgical intervention. [8] Retrospective reviews demonstrate failure of the procedure in 6.5% of patients.
In medicine, a distal splenorenal shunt procedure (DSRS), also splenorenal shunt procedure and Warren shunt, [1] is a surgical procedure in which the distal splenic vein (a part of the portal venous system) is attached to the left renal vein (a part of the systemic venous system).