Related Experiment Video
Updated: Sep 24, 2025
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Ideal trajectory for frontal ventriculostomy: Radiological study and anatomical study
Vera Vigo1, Anna Tassinari2, Alba Scerrati2
1Department of Neurological Surgery, Stanford University, Palo Alto, CA, USA; The Stanford Neurosurgical Training and Innovation Center, Stanford University, Palo Alto, CA, USA; Neurosurgery Unit, Ferrara University Hospital, Department of Morphology Surgery and Experimental Medicine, Ferrara, Italy.
This study developed a standardized protocol for freehand frontal ventriculostomy, improving catheter accuracy. The new method demonstrated a higher success rate in reaching the Foramen of Monro (FM) in anatomical studies.
Area of Science:
- Neurosurgery
- Medical Imaging
- Anatomy
Background:
- Frontal ventriculostomy accuracy is crucial for reducing complications.
- Existing techniques lack reliability, cost-effectiveness, and consistency.
- A standardized protocol for freehand frontal ventriculostomy is needed.
Purpose of the Study:
- To provide a standardized protocol for freehand frontal ventriculostomy.
- To improve the accuracy of catheter placement.
- To reduce complications associated with suboptimal catheter tip placement.
Main Methods:
- Radiological analysis of 125 CT scans to determine catheter length from two entry points.
- Analysis of 50 CT scans using a 24-point grid to measure distance to the Foramen of Monro (FM).
- Ventriculostomy performed on six cadaveric heads using a 9-point grid, comparing syringe and freehand techniques.
Main Results:
- Mean length from cranial surface to FM was 67.38 ± 1.03 mm.
- No statistical difference in mean length from 24 selected points (68.54 ± 2.73 mm).
- Freehand technique achieved 57.4% FM targeting vs. 14.8% with syringe; 79.6% ventricular entry vs. 68.5% with syringe.
Conclusions:
- The study identified the optimal length for frontal ventricular catheters.
- The frontal bone above superior temporal lines approximates a sphere centered at the FM.
- A standardized freehand protocol enhances accuracy and target acquisition in ventriculostomy.
