Anterograde ventricular irrigation during fourth ventricle region surgery.

OBJECTIVE To reduce postoperative hydrocephalus following surgery in the region of the fourth ventricle. METHOD/TECHNIQUE: We describe the use of a conventionally placed lateral ventricular catheter to facilitate anterograde ventricular irrigation during surgery in the region of the fourth ventricle. This technique offers a safe alternative to more conventional approaches to fourth ventricular irrigation and obviates the need for placement of a third or fourth ventricular catheter and/or serial lumbar punctures by thoroughly flushing blood and tissue debris from the operative field at the time of surgery. RESULTS Preliminary results spanning a five-year period show a lower incidence in the need for early ventriculo-peritoneal shunts (5%) and delayed ventriculo-peritoneal shunts (10%). CONCLUSION This technique represents a safe method of reducing hydrocephalus following operative procedures in the region of the fourth ventricle.