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Coma due to malplaced external ventricular drain.

Feng Yih Chai¹, Fadzil Farizal, Thanabalan Jegan

¹University of Kebangsaan Malaysia, Department of Surgery, Cheras, Kuala Lumpur, Malaysia.

Turkish Neurosurgery

|October 9, 2013

Summary

This summary is machine-generated.

Free-hand external ventricular drain (EVD) placement can lead to malplacement. This report details the first coma case caused by a misplaced EVD, resolved by adjustment, highlighting image guidance benefits.

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Area of Science:

Neurosurgery
Neurology
Medical Devices

Background:

Free-hand technique for external ventricular drain (EVD) placement is associated with a high rate of malposition.
This blind procedure frequently necessitates multiple attempts and revisions, increasing procedural risks.

Observation:

The study presents a unique case of induced coma resulting from a malplaced EVD.
The patient regained consciousness after the external ventricular drain was repositioned.

Findings:

This is the first reported instance of neurological complications, specifically coma, directly attributed to external ventricular drain malplacement.
The hypothesized cause is the mass effect and irritation from the misplaced drain on the ventral periaqueductal gray matter and ascending brainstem neurons.

Implications:

Image-guided EVD insertion offers improved accuracy and potentially fewer complications compared to free-hand techniques.
This case underscores the critical need for precise EVD placement to avoid severe neurological deficits.