title: Neural injury by frontal approach of external ventricular drainage in stroke patients.
abstract: OBJECTIVE
  No study on the characteristics of injury of neural tracts following external ventricular drainage (EVD) in a large number of consecutive patients following EVD has been reported. In this study, using diffusion tensor tractography (DTT), we attempted to investigate the characteristics of injury of neural tracts associated with EVD using a frontal approach in stroke patients.
  
  
  METHODS
  We recruited 43 consecutive hemorrhagic stroke patients with a history of EVD using a frontal approach. Five neural tracts were reconstructed [corticospinal-tract (CST), corticoreticular-pathway (CRP), arcuate-fasciculus (AF), cingulum, and superior-longitudinal-fasciculus (SLF)].
  
  
  RESULTS
  Among five neural tracts, neural injury by EVD was observed on only two neural tracts (the CRP and the cingulum): CRP-seven (16.3%, five patients-partial tearing and two patients-complete discontinuation) of 43 patients and cingulum-eight (18.6%, eight patients-complete discontinuation of the anterior portion of the cingulum) of 43 patients.
  
  
  CONCLUSIONS
  It appears that neural injury occurred in a considerable number of patients who underwent EVD; therefore, conduct of further studies on measures to prevent or minimize neural injury by EVD should be encouraged.
authors.affiliation: a Department of Physical Medicine, Neurosurgery, and Rehabilitation , College of Medicine, Yeungnam University , Republic of Korea.
authors.forename: Yong Min
authors.initials: YM
authors.lastname: Kwon
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
mesh_terms: D002540:Cerebral Cortex / Q000473:pathology*; D002552:Cerebral Ventricles / Q000601:surgery*; D056324:Diffusion Tensor Imaging; D004322:Drainage / Q000009:adverse effects* / Q000379:methods; D018728:Entorhinal Cortex / Q000473:pathology*; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000473:pathology; D059906:Neuroimaging; D012154:Reticular Formation / Q000473:pathology*; D020521:Stroke / Q000150:complications* / Q000473:pathology / Q000601:surgery*
keywords: diffusion tensor tractography; external ventricular drainage; neural tract injury; stroke