is a procedure performed to drain cerebrospinal fluid from
the brain. At the same time, the pressure in the brain
can be accurately monitored. There are a number of reasons
why cerebrospinal fluid may build up in the brain (tumor,
meningitis, hemorrhage, and others).
may be placed at the patient's bedside or in the operating
room. The patient may be sedated if required, and a
local anesthetic is used. A "twist drill"
hole is made in the skull, and a catheter (tube) is placed
through it, into the frontal horn of the lateral ventricle
(placed through the lobe in the front of the brain, into a
fluid filled cavity known as the ventricle). Through
this tube, fluid can be withdrawn if the pressure in the brain
becomes too high, and the intracranial pressure can be continually
for ventriculostomy can be broken down into two categories,
1) those related to the operative site, and 2) those related
to the risks of anesthesia.
related to the operative site
Exposure: The patient is placed on their back.
The incision in the scalp is small. There is risk
of non healing of the scalp or bone post operatively.
injury: The surgery involves placing a tube through
the surface of the brain into the ventricle (fluid filled
cavity within the brain). The ventricle is sometimes
difficult to "hit" or target, and several "passes"
of the tube through the brain may be necessary. Each
pass carries risk of brain damage and bleeding. There
could be bleeding if an artery or vein is hit, and this
could require emergent surgery to open the skull and remove
the clot. If there is injury to the brain, it
could result in weakness, seizures, stroke, paralysis, coma
or death. There may be residual fluid or blood, requiring
additional surgery in the future. Damage to the frontal
lobes of the brain may result in personality changes.
These include such general difficulties as bleeding,
infection, stroke, paralysis, coma and death. Incisions
on the scalp generally heal well, but could become
tender, numb, or may heal in an unpleasant manner.
There is also the possibility that the surgery may not relieve
the symptoms for which the procedure was performed.
The catheter in the brain is connected to a drainage bag,
which is external to the body. This means that there
is a slightly higher risk of infection, than if the tube
were completely internal.
of Anesthesia: Blood clots in the legs, heart attacks,
reaction to the anesthetic, reaction to blood transfusion,
a patient is not discharged home with a ventriculostomy in
place, but is cared for by the nurses in the hospital, the
postoperative care will be performed by the nurses in the