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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.
If the procedure does not successfully cure the aqueductal stenosis, a second surgery can be performed to enlarge the incision or implant a shunt. Problems that can lead to these failures and require additional surgery include the stoma becoming closed or a new membrane forming across the stoma over time. Currently there is no universal ...
The revision of a shunt means to replace or make adjustments to all or part of the shunt, this also means that the location of the shunt may be changed therefore changing the category or type of shunt a patient has. For some patients with shunts, a revision or multiple revisions to the shunt may be required. This can be something minor, such as ...
Elmer, Richard M. "'How Great Thou Art! "The Vicissitudes of a Hymn." The Hymn 9 (January 1958):18–20. A discussion of the two translations of the text by E. Gustav Johnson and Hine. Richardson, Paul A. "How Great Thou Art." Church Musician 39 (August 1988):9–1 1. A Hymn of the Month article on the text by Carl Boberg as translated by Hine.
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.
A left-to-right shunt is when blood from the left side of the heart goes to the right side of the heart. This can occur either through a hole in the ventricular or atrial septum that divides the left and the right heart or through a hole in the walls of the arteries leaving the heart, called great vessels.