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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.
The most definitive way of measuring the intracranial pressure is with transducers placed within the brain. A catheter can be surgically inserted into one of the brain's lateral ventricles and can be used to drain CSF (cerebrospinal fluid) in order to decrease ICPs. This type of drain is known as an external ventricular drain (EVD). [10]
Of these, external ventricular drainage (EVD) ventriculostomy is the current gold standard as it allows physicians to both monitor ICP and treat if necessary. Some non-invasive intracranial pressure measurement methods are currently being studied, however none are currently able to deliver the same accuracy and reliability of invasive methods.
It is located on the parietal bone, above the lambdoid suture, 3 to 4 cm lateral to the midline and 6 cm above the inion. [11] It is a common site for ventricular cannulation in the context of inserting a ventriculoperitoneal shunt for the treatment of hydrocephalus. It was first described by C H Frazier in 1928. [12]
It is done by surgically penetrating the skull, dura mater, and brain such that the ventricular system ventricle of the brain is accessed. When catheter drainage is temporary, it is commonly referred to as an external ventricular drain (EVD). When catheter drainage is permanent, it is usually referred to as a shunt.
It is a subject of research in animals and human clinical trials. As of 2012, the lowest body temperature ever survived by a human being was 9 °C (48 °F) as part of a hypothermic circulatory arrest experiment to treat cancer in 1957. [33] [34] This temperature was reached without surgery, using external cooling alone. Similar low temperatures ...
Impedance cardiography (ICG) is a non-invasive technology measuring total electrical conductivity of the thorax and its changes in time to process continuously a number of cardiodynamic parameters, such as stroke volume (SV), heart rate (HR), cardiac output (CO), ventricular ejection time (VET), pre-ejection period and used to detect the impedance changes caused by a high-frequency, low ...
For patients with an implanted external ventricular drain, cerebrospinal fluid can be collected from the drain's output. After the sample of fluid is obtained, a battery of tests featuring gram staining will be performed to identify any offending pathogen or infection agent. The test will also determine any resistance the pathogen may have to ...