Proposed Simple, Efficient Free Hand Technique for Frontal External Ventricular Drain (EVD) in Case of Small Ventricle: A Report of New Technique

Background: EVD is a common procedure done in neurosurgery and the residents should master it this what exactly means that be simple, safe, fast accurate. can through many entry points to different part of lateral ventricle but famous site anterior horn which commonly approached Kocher’s point for all neurosurgeon by its measurements allocation. The commonest problem with insertion into navigation ventricular cavity right trajectory so location catheter tip place near foramen monro ensure CSF draining. Size plays significant role success especially free hand technique. more dilated ventricle, chance hit from first trial vice versa. In case small technique seems complicated may reduce non-expert surgeon succeed following trials increased risk complications trials. Purpose: Most EVD’s are placed freehand depends on operator skills navigate trial, because complicate produce undesirable side effects. So key how trial. even difficult classic Kocher needs an expert get such ventricle. Our idea came prospective aimed at raising attempt simple Method: It new frontal burr hole gained intersection two lines: running vertically ipsilateral medial canthus downward second horizontal along coronal suture usually palpable as ridge scalp extended bregma. Burr just perpendicular toward cavity. Result: has been used about (n = 50 cases) fulfilling criteria radiological defined they were candidates Only 3 cases (6%) out failed succeeded high rate seen most using during period one year our practice without effects seen. Conclusion: study not conclusive further studies evaluation. was suggested other than We recommend try report any advantages or disadvantages literature.