title: Paediatric External Ventricular Drains: Experience from a tertiary care hospital of a Developing Country.
abstract: The aim of the study was to describe indications and complications of external ventricular drain (EVD) placement in children aged between 1 month and 16 years. This retrospective chart review was conducted at the Aga Khan University Hospital, Karachi, and comprised all children who underwent EVD placement from January 2007 to December 2014. Of the 177 patients identified, 117(66%) were males 60(34%) were girls. The overall mean age was 5.4±5.2 years. The median Glasgow Coma Scale score on presentation and discharge was 13 (interquartile range [IQR]: 7) and 15 (IQR: 4), respectively. Major diagnosis included intracranial tumour 60(34%), bacterial meningitis 34(19%), tuberculous meningitis 33(18.6%), and haemorrhage 23(13%). Clinical indications for EVD insertion were acute hydrocephalus secondary to infection 64(36.2%), tumour 54(30.5%), and haemorrhage 23(13%) ventriculoperitoneal shunt malfunction or infection 25(14.1%) and traumatic brain injury 11(6.2%). Complications were observed in 47(26%) patients including infections 25(14.1%), malfunction 11(6.2%), haemorrhage 6(3.4%), misplacement 3(1.7%) and obstruction 2(1.1%). Staphylococcus was the main organism isolated. Moreover, 25(14%) patients expired. Acute hydrocephalus was the major indication and EVD infection was the major complication.
authors.affiliation: Department of Pediatrics and Child Health, Aga Khan University, Karachi.
authors.forename: Abbas
authors.initials: A
authors.lastname: Qalab
authors.affiliation: Student, Section of Neurosurgery, Aga Khan University, Karachi.
authors.forename: Rayaan
authors.initials: R
authors.lastname: Asad
authors.affiliation: Department of Pediatrics and Child Health, Aga Khan University, Karachi.
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Hakeem
authors.affiliation: Department of Pediatrics and Child Health, Aga Khan University, Karachi.
authors.forename: Maria
authors.initials: M
authors.lastname: Ahmed
authors.affiliation: Department of Surgery, Section of Neurosurgery, Aga Khan University, Karachi.
authors.forename: Haque
authors.initials: H
authors.lastname: Anwar
authors.affiliation: Department of Surgery , Aga Khan University, Karachi.
authors.forename: Aneela
authors.initials: A
authors.lastname: Darbar
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D004322:Drainage; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000628:therapy*; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D017287:Ventriculoperitoneal Shunt
keywords: EVD, Paediatric, Hydrocephalus, Infections, Complications.