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Updated: Aug 31, 2026

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
Published on: March 26, 2019
Training protocol for intracranial pressure monitor placement by nonneurosurgeons: 5-year experience
1Department of Neurological Surgery, Cornell University, New York, NY 10021, USA. kgyrus@attglobal.net
Background:
This report evaluates a protocol for training nonneurosurgeon medical staff to perform ventricular catheter placement for ICP monitoring in traumatic brain injury and other appropriate patients under the guidance of neurosurgeons.
Methods:
Eleven neurosurgery house officers were enrolled in the program to be certified for ventricular catheter placement. The training program using the Ghajar Guide is described as well as the preprocedural checklist. The results of these certified house officers were tracked over a 5-year period.
Results:
Ten house officers successfully completed the certification process for ventricular catheter placement in a total of 106 patients. The majority of ventricular catheters were placed at the bedside. The reported results and the complication rates of catheter-related infections and intracranial hemorrhage are similar to that of neurosurgeons or neurosurgeons in training.
Conclusion:
House officers under the guidance of neurosurgeons can be trained to successfully and safely place ventricular catheters for ICP monitoring in patients needing ICP monitoring.

