• Andrea Saladino, J Bradley White, Eelco F M Wijdicks, and Giuseppe Lanzino.
• Department of Neurologic Surgery, The Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
• Neurocrit Care. 2009 Jan 1;10(2):248-52.

IntroductionThe placement of cerebrospinal fluid (CSF) diversion devices requires an appropriate technical expertise associated with proper surgical training in order to minimize undue complications. This study sought to review a single institution's experience with placement of external ventricular drains (EVD) and ventriculoperitoneal (VP) shunts as performed by neurosurgeons with procedure-specific training.MethodsA retrospective database review was conducted for all patients who underwent intraventricular CSF diversion over a 5-year period from March 2003 to February 2008. Included in the analysis were ventriculostomy procedures that included EVDs, VP shunts, and ventriculoatrial shunts.ResultsA total of 138 patients underwent 212 ventriculostomy procedures. Seventy-one (51%) patients were male and sixty-seven (49%) were female. The median age was 50.1 years. A ventriculostomy-related hemorrhage was identified in 15 (7.1%) patients-4 of whom developed new symptoms. Twenty-six (12.3%) ventriculostomy catheters were malplaced as determined from post-procedural imaging. Ventriculostomy-related infections were identified in 7 (3.3%) patients, 4 of whom had EVDs and 3 of whom had VP shunts.ConclusionThe placement of intraventricular catheters by neurosurgeons remains a relatively safe and effective procedure that is associated with infrequent rates of symptomatic hemorrhage and infection.

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