title: Percutaneous computed tomographic-controlled ventriculostomy in severe traumatic brain injury.
abstract: OBJECTIVE
  Percutaneous computed tomographic (CT)-controlled ventriculostomy (PCV) was introduced for the monitoring of intracranial pressure in patients with severe traumatic brain injury who did not require simultaneous decompressive trepanation.
  
  
  METHODS
  PCV (n = 14) was compared with conventional burr hole ventriculostomy (n = 13) based on prospectively collected data.
  
  
  RESULTS
  PCV proved to be a successful technique in all cases and also when a burr hole ventriculostomy was impossible previously. There were no complications. In burr hole ventriculostomy, there were one unsuccessful insertion and one catheter contamination. The main advantage of PCV over burr hole ventriculostomy was a significant (p < 0.05) reduction in the time required to perform the procedure. In ventriculostomy directly after the initial evaluation in the emergency department, the operation time was reduced from 45 +/- 11 to 22 +/- 14 minutes. The interval between cranial computed tomography and start of operation was reduced from 78 +/- 38 to 33 +/- 12 minutes, and between initial cranial computed tomography and intensive care unit admittance, from 138 +/- 37 to 73 +/- 28 minutes. For patients requiring ventriculostomy while being treated in the intensive care unit, the duration of the procedure (i.e., absence from the intensive care unit) was able to be reduced from 111 +/- 24 to 81 +/- 21 minutes.
  
  
  CONCLUSIONS
  Distinct time savings are the major advantages of PCV, allowing exact catheter positioning even with very narrow ventricles.
authors.affiliation: Department of Surgery, Klinikum Innenstadt, Ludwig-Maximilians-University of Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Ruchholtz
authors.forename: C
authors.initials: C
authors.lastname: Waydhas
authors.forename: A
authors.initials: A
authors.lastname: Müller
authors.forename: U M
authors.initials: UM
authors.lastname: Lewan
authors.forename: D
authors.initials: D
authors.lastname: Nast-Kolb
authors.forename: E
authors.initials: E
authors.lastname: Euler
authors.forename: K J
authors.initials: KJ
authors.lastname: Pfeiffer
authors.forename: L
authors.initials: L
authors.lastname: Schweiberer
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices; D014696:Ventriculostomy / Q000379:methods*