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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.
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 ...
Techniques such as angioplasty, stenting, clot retrieval, embolization, and diagnostic angiography are endovascular procedures. [44] 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 ...
Jones et al. have treated 4 patients with non-communicating hydrocephalus who had VP shunt infections with shunt removal and third ventriculostomy. These patients were cured of the infection and have not required shunt re-insertion, thus showing the effectiveness of this procedure in these types of patients. [33]
Shunt surgery is one of the most common procedures in pediatric neurosurgery. Significant advances in shunt technology and surgical approaches have been made over the years. However, the lifetime risk for a revision surgery of a ventriculoperitoneal shunt in pediatric patients can reach up to 80%. [60] Shunt failure rates are also high.
A Peritoneovenous shunt: (also called Denver shunt) [2] is a shunt which drains peritoneal fluid from the peritoneum into veins, usually the internal jugular vein or the superior vena cava. It is sometimes used in patients with refractory ascites. It is a long tube with a non-return valve running subcutaneously from the peritoneum to the ...