title: Novel entry point for intraoperative ventricular puncture during the transsylvian approach.
abstract: OBJECTIVE
  In dealing with cases of oedematous brain, relaxation during the transsylvian approach to supratentorial aneurysms has been accomplished by ventricular drainage by using the anatomic point defined by Dr. Paine. However, we have experienced patient complications when using this point. We propose a novel anatomic point to reduce catheter-related complications and facilitate adequate ventricular puncture during ruptured aneurysm operations.
  
  
  METHODS
  Ten patients underwent aneurysmal neck clipping for ruptured aneurysm by means of the transsylvian approach. The use of a novel anatomic point for intraoperative drainage was examined using a neuronavigation system.
  
  
  RESULTS
  Using the novel point of entry for ventricular cannulation proved to be reliable for puncture and reduced chance of malpositioning.
  
  
  CONCLUSIONS
  Secure intraoperative ventricular cannulation is reliably achieved by pointing the catheter approximately 2 cm beyond a line extending from the anterior limb of the triangle described by Paine. This technique reduces injury to the deep brain and enhances preciseness and safety of ventricular cannulation.
authors: Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Korea.
authors: S J
authors: SJ
authors: Hyun
authors: J S
authors: JS
authors: Suk
authors: J T
authors: JT
authors: Kwon
authors: Y B
authors: YB
authors: Kim
mesh_terms: D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000601:surgery*; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000601:surgery; D002404:Catheterization / Q000379:methods; D004322:Drainage / Q000379:methods; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000601:surgery; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D038361:Neuronavigation / Q000379:methods*; D011677:Punctures / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014696:Ventriculostomy / Q000379:methods*