Related Experiment Video

Updated: May 8, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
14:59

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Published on: October 14, 2022

Indications for pediatric external ventricular drain placement and risk factors for conversion to a

Corey T Walker1, Jonathan J Stone, Max Jacobson

  • 1Department of Neurological Surgery, University of Rochester Medical Center, Rochester, N.Y., USA.

Pediatric Neurosurgery
|August 15, 2013
PubMed

Insights

External ventricular drains (EVDs) are common for pediatric hydrocephalus. Trauma is a leading indication, with most patients avoiding long-term shunts, unlike those with neoplasms.

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Critical Care Medicine

Background:

  • External ventricular drains (EVDs) are crucial for managing hydrocephalus and monitoring intracranial pressure (ICP) in pediatric patients.
  • Understanding the long-term implications of EVD placement is essential for optimizing patient care.

Purpose of the Study:

  • To review the indications for EVD placement in pediatric patients over a 20-year period.
  • To evaluate the rate of conversion from EVD to ventriculoperitoneal shunt (VPS).
  • To determine how hydrocephalus etiology affects long-term drainage requirements.

Main Methods:

  • Retrospective review of pediatric patients who received their first EVD between 1990 and 2010.
  • Data collected included demographics, hydrocephalus etiology, length of stay, and EVD duration.
  • Exclusion of patients with prior ventricular catheters or shunts.

Main Results:

  • Trauma (43.3%) and neoplasms (32.2%) were the most frequent indications for EVD placement.
  • Approximately 25% of patients required conversion to a VPS for long-term cerebrospinal fluid diversion.
  • Patients with traumatic brain injury had a significantly lower risk of VPS conversion (RR=0.18) compared to other etiologies.

Conclusions:

  • Traumatic brain injuries and neoplasms are primary indications for pediatric EVDs.
  • While neoplasms significantly increase the likelihood of requiring a VPS (RR=3.56), most EVDs in head injury patients are successfully weaned.
  • Etiology of hydrocephalus critically influences the need for long-term CSF diversion.
Abstract

Related Concept Videos

Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Mechanical Ventilation I: Indication and Settings01:29

Mechanical Ventilation I: Indication and Settings

Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...