Bedside external ventricular drain placement for the treatment of acute hydrocephalus

The purpose of this retrospective study was to evaluate the results of exte rnal ventricular drain (EVD) placement for the management of hydrocephalus. We present our experience with 103 consecutive cases over one year, 56 of which had subarachnoid hemorrhage (SAH). Short tunnel ventriculostomy was p erformed at the bedside in the neurosurgical intensive care unit (NSICU), u sing sterile technique. Long-term care included meticulous site care by a d edicated NSICU nurse, daily cultures and prophylactic antibiotics. The aver age duration of EVD was 10.7 days (range 1-28 days). There was one case of positive cerebrospinal fluid (CSF) culture. Additional complications includ ed one small intraparenchymal hematoma and two cases of EVD disconnection. No patient died form EVD-associated complications. No rebleed from aneurysm al SAH was seen. There was no correlation between the duration of EVD and i nfection. We conclude that placement of short EVD in the NSICU is safe and can be maintained for the required duration of treatment with minimum infec tion rate.