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Updated: Jun 25, 2026

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
06:18

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury

Published on: March 26, 2019

Hemorrhage rates after external ventricular drain placement.

Paul A Gardner1, Johnathan Engh, Dave Atteberry

  • 1Department of Neurological Surgery, University of Pittsburgh, Pennsylvania, USA. gardpa@upmc.edu

Journal of Neurosurgery
|February 10, 2009
PubMed
Summary

External ventricular drain (EVD) placement carries a significant risk of hemorrhage, though most are minor. Larger hemorrhages are rare and rarely require surgical intervention, indicating a generally safe procedure.

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Last Updated: Jun 25, 2026

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
06:18

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury

Published on: March 26, 2019

Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Devices

Background:

  • External ventricular drain (EVD) placement is a common neurosurgical procedure.
  • The incidence and clinical significance of hemorrhage associated with EVD placement are not well-established.

Purpose of the Study:

  • To quantify the rates and significance of hemorrhage following external ventricular drain placement.
  • To evaluate factors influencing hemorrhage risk, such as placement location.

Main Methods:

  • Retrospective review of adult patients undergoing EVD placement at a single academic medical center.
  • Inclusion criteria: EVD placement between July 2002 and June 2003 with postprocedural imaging.
  • Exclusion criteria: Patients without postprocedural imaging.

Main Results:

  • Hemorrhage was observed in 41% of 188 EVD placements.
  • Most hemorrhages were minor (punctate intraparenchymal or trace subarachnoid) (51.9%).
  • Larger hemorrhages occurred in 19.7% of cases, with only one requiring surgical evacuation for a subdural hematoma.

Conclusions:

  • External ventricular drain placement is associated with a notable risk of hemorrhage.
  • The majority of hemorrhages are clinically insignificant and do not necessitate surgical intervention.
  • While a trend suggests lower risk in the operating room versus ICU, it was not statistically significant.