• Jaechan Park, Yeon-Ju Choi, Boram Ohk, and Hyun-Ha Chang.
• Department of Neurosurgery, Department of Internal Medicine, Kyungpook National University, Daegu, Republic of Korea; Research Center for Neurosurgical Robotic Systems, Department of Internal Medicine, Kyungpook National University, Daegu, Republic of Korea. Electronic address: jparkmd@hotmail.com.
• World Neurosurg. 2018 Jan 1; 109: e398-e403.

ObjectiveThe placement of a ventricular catheter for temporary cerebrospinal fluid (CSF) diversion is associated with a considerable risk of CSF infection. The authors investigated the effect of a CSF leak on CSF-related infection and the predisposing factors for a CSF leak.MethodsFifty-two patients who underwent external ventricular drainage (EVD) for acute hydrocephalus associated with a subarachnoid hemorrhage or intraventricular hemorrhage (IVH) were enrolled in this prospective study. A CSF leak-detection paper (small sterilized filter paper) was applied at the percutaneous catheter exit site to check for any bloody CSF leak. In addition, radiologic and clinical data were collected.ResultsFour of the 52 patients (7.7%) developed an EVD-related CSF infection from organisms including Staphylococcus epidermidis (n = 3) and Staphylococcus hominis (n = 1). A prolonged CSF leak >1 day was detected in 9 patients (17.3%) and revealed as a significant risk factor for CSF infection with a 44.4% positive predictive value. Moreover, an IVH >10 mL was found in 11 patients (21.2%) and revealed as a significant predisposing factor for a CSF leak at the percutaneous catheter exit.ConclusionsA prolonged CSF leak for >1 day at the percutaneous catheter exit site is a crucial risk factor for EVD-related CSF infection and an IVH >10 mL is a predisposing factor for a CSF leak.Copyright © 2017 Elsevier Inc. All rights reserved.

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