Ventriculostomy
Encyclopedia
Ventriculostomy is a neurosurgical
procedure that involves creating a hole ("ostomy") within a cerebral ventricle for drainage. It is done by surgically penetrating the skull
, dura mater, and brain such that the ventricle
of the brain is accessed. When catheter drainage is temporary, it is commonly referred to as an external ventricular drain, or EVD. When catheter drainage is permanent, it is usually referred to as a shunt. There are many catheter-based ventricular shunts that are named for where they terminate, for example, a ventriculo-peritoneal shunt terminates in the peritoneal cavity, a ventriculoatrial shunt ternimates within the atrium of the heart, etc. The most common entry point on the skull is called Kocher's point
, which is measured 11 cm posterior to the nasion and 3 cm lateral to midline. EVD ventriculostomy is done primarily to monitor the intracranial pressure as well as to drain CSF
(primarily) or blood to relieve pressure from the CNS
.
Strictly speaking, "ventriculotomy" does not require the use of tubing. For example, a "third ventriculostomy" is a neurosurgical procedure that creates a hole in the floor of the third ventricule and usually has no indwelling objects.
Other types ventriculostomy include ventriculocisternostomy developed by the Norwegian doctor Arne Torkildsen
.
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
procedure that involves creating a hole ("ostomy") within a cerebral ventricle for drainage. It is done by surgically penetrating the skull
Human skull
The human skull is a bony structure, skeleton, that is in the human head and which supports the structures of the face and forms a cavity for the brain.In humans, the adult skull is normally made up of 22 bones...
, dura mater, and brain such that the ventricle
Ventricular system
The ventricular system is a set of structures containing cerebrospinal fluid in the brain. It is continuous with the central canal of the spinal cord.-Components:The system comprises four ventricles:* right and left lateral ventricles* third ventricle...
of the brain is accessed. When catheter drainage is temporary, it is commonly referred to as an external ventricular drain, or EVD. When catheter drainage is permanent, it is usually referred to as a shunt. There are many catheter-based ventricular shunts that are named for where they terminate, for example, a ventriculo-peritoneal shunt terminates in the peritoneal cavity, a ventriculoatrial shunt ternimates within the atrium of the heart, etc. The most common entry point on the skull is called Kocher's point
Kocher's point
Kocher's point is a common entry point for an intraventricular catheter to drain cerebral spinal fluid from the cerebral ventricles. It is located 2.5 centimeters from the midline approximately 11 cm posterior to the nasion. It is important to be at least 1 cm anterior to the coronal...
, which is measured 11 cm posterior to the nasion and 3 cm lateral to midline. EVD ventriculostomy is done primarily to monitor the intracranial pressure as well as to drain CSF
Cerebrospinal fluid
Cerebrospinal fluid , Liquor cerebrospinalis, is a clear, colorless, bodily fluid, that occupies the subarachnoid space and the ventricular system around and inside the brain and spinal cord...
(primarily) or blood to relieve pressure from the CNS
Central nervous system
The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...
.
Strictly speaking, "ventriculotomy" does not require the use of tubing. For example, a "third ventriculostomy" is a neurosurgical procedure that creates a hole in the floor of the third ventricule and usually has no indwelling objects.
Other types ventriculostomy include ventriculocisternostomy developed by the Norwegian doctor Arne Torkildsen
Arne Torkildsen
Arne Torkildsen was a Norwegian neurosurgeon. He described the surgical technique of ventriculocisternostomy , which is also called "Torkildsen's operation".-External links:* - biographic article in the Journal of the Norwegian Medical Association....
.