The Evolution of the Role of External Ventricular Drainage in Traumatic Brain Injury

Charlene Y C Chau; Claudia L Craven; Andres M Rubiano; Hadie Adams; Selma Tülü; Marek Czosnyka; Franco Servadei; Ari Ercole; Peter J Hutchinson; Angelos G Kolias

doi:10.3390/jcm8091422

The Evolution of the Role of External Ventricular Drainage in Traumatic Brain Injury

J Clin Med. 2019 Sep 10;8(9):1422. doi: 10.3390/jcm8091422.

Authors

Charlene Y C Chau¹, Claudia L Craven², Andres M Rubiano^{3

4}, Hadie Adams¹, Selma Tülü^{1

5}, Marek Czosnyka¹, Franco Servadei⁶, Ari Ercole⁷, Peter J Hutchinson^{1

4}, Angelos G Kolias^{8

9}

Affiliations

¹ Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge CB20QQ, UK.
² Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N3BG, UK.
³ Neurosciences Institute, INUB-MEDITECH Research Group, El Bosque University, 113033 Bogotá, Colombia.
⁴ NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge CB20QQ, UK.
⁵ Department of Neurosurgery, Innsbruck Medical University, 6020 Innsbruck, Austria.
⁶ Department of Neurosurgery, Humanitas University and Research Hospital, 20090 Milan, Italy.
⁷ Division of Anaesthesia, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge CB20QQ, UK.
⁸ Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge CB20QQ, UK. angeloskolias@gmail.com.
⁹ NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge CB20QQ, UK. angeloskolias@gmail.com.

Abstract

External ventricular drains (EVDs) are commonly used in neurosurgery in different conditions but frequently in the management of traumatic brain injury (TBI) to monitor and/or control intracranial pressure (ICP) by diverting cerebrospinal fluid (CSF). Their clinical effectiveness, when used as a therapeutic ICP-lowering procedure in contemporary practice, remains unclear. No consensus has been reached regarding the drainage strategy and optimal timing of insertion. We review the literature on EVDs in the setting of TBI, discussing its clinical indications, surgical technique, complications, clinical outcomes, and economic considerations.

Keywords: EVD; ICP; TBI; intracranial pressure; neurosurgery; neurotrauma; ventriculostomy.

Publication types

Review

Grants and funding

G0601025/MRC_/Medical Research Council/United Kingdom