Percutaneous computed tomographic-controlled ventriculostomy in severe traumatic brain injury

Area of Science:

• Neurosurgery
• Trauma Care
• Medical Imaging

Background:

• Severe traumatic brain injury (TBI) often necessitates intracranial pressure (ICP) monitoring.
• Conventional burr hole ventriculostomy can be time-consuming and technically challenging.
• Percutaneous computed tomographic (CT)-controlled ventriculostomy (PCV) was developed as an alternative.

Purpose of the Study:

• To evaluate the efficacy and safety of PCV compared to conventional burr hole ventriculostomy.
• To assess the time efficiency of PCV in patients with severe TBI.
• To determine the feasibility of PCV, particularly in cases where conventional methods are difficult.

Main Methods:

• A prospective comparative study involving 14 patients undergoing PCV and 13 patients undergoing conventional burr hole ventriculostomy.
• Data collected prospectively on procedure time, success rates, and complications.
• Comparison focused on time intervals: operation time, time from CT to operation, and time from initial CT to ICU admission.

Main Results:

• PCV was successful in all cases, including those where burr hole ventriculostomy was previously impossible.
• PCV demonstrated a significant reduction (p < 0.05) in procedure time compared to conventional methods.
• Specific time savings observed for operation duration, pre-operative intervals, and time away from the ICU.

Conclusions:

• Percutaneous CT-controlled ventriculostomy offers substantial time savings for ICP monitoring in severe TBI.
• The technique ensures precise catheter placement, even in patients with narrow ventricles.
• PCV is a safe and effective alternative to conventional burr hole ventriculostomy, improving procedural efficiency.