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Accuracy of ultrasound-guided puncture of the ventricular system

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Abstract

Objects

Puncture of the ventricular system as one of the most frequently performed operative procedures in neurosurgery is usually done in a freehand way without guiding devices. The objective of this study is to examine whether ultrasonic guidance is able to heighten the accuracy of ventricular tapping.

Methods

Real-time imaging via a single burr hole approach is achieved by aid of a bajonet-like shaped transducer with a footprint of 8x8 mm only (EUP-NS32, Hitachi Medical Systems). The needle is advanced towards the frontal horn along a displayed guideline. 51 punctures in 48 patients were performed with ultrasonic guidance and compared to 85 punctures in 67 patients without a guiding device.

Conclusion

The presented ultrasound method was not able to heighten the access rate of ventricular tapping, but it improved correct positioning of the catheter tip inside the frontal horn of the ventricular system significantly.

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References

  1. Bode H, Strassburg HM, Bohlayer R, Gilsbach HJ (1985) Sonographic position and functional diagnosis of ventricular positioned shunt systems in infants with hydrocephalus. Klin Padiatr 197:94–97, (Ger)

    PubMed  CAS  Google Scholar 

  2. Choudhury AR (1993) CT measurement of the ventricular catheter length in shunt surgery. Br J Neurosurg 7:541–544

    Article  PubMed  CAS  Google Scholar 

  3. Dickerman RD, McConathy WJ, Morgan J, Stevens QE, Jolley JT, Schneider S, Mittler MA (2005) Failure rate of frontal versus parietal approaches for proximal catheter placement in ventriculoperitoneal shunts: revisited. J Clin Neurosci 12:781–783

    Article  PubMed  CAS  Google Scholar 

  4. Frank E, Kohler E, Hein L (1989) A modification of the Brown–Roberts–Wells stereotactic frame for implantation of ventricular access reservoirs. Neurosurgery 25:839–841

    Article  PubMed  CAS  Google Scholar 

  5. Ghajar JB (1985) A guide for ventricular catheter placement. J Neurosurg 63:985–986

    PubMed  CAS  Google Scholar 

  6. Gil Z, Siomin V, Beni-Adani L, Ben Sira L, Constantini S (2002) Ventricular catheter placement in children with hydrocephalus and small ventricles: the use of a frameless neuronavigation system. Child’s Nerv Syst 18:26–29

    Article  Google Scholar 

  7. Gomez CR (1995) Ultrasonic ventriculostomy stylet. Neurosurgery 37:1020–1021

    Article  PubMed  CAS  Google Scholar 

  8. Howard MA 3rd, Srinivasan J, Bevering CG, Winn HR, Grady MS (1995) A guide to placement of parietooccipital ventricular catheters. Technical note. J Neurosurg 82:300–304

    PubMed  Google Scholar 

  9. Imaizumi S, Onuma T, Mino M, Kameyama M, Motohashi O (2001) Free hand aspiration for large periventricular hemorrhage. Case report. Surg Neurol 55:376–377

    Article  PubMed  CAS  Google Scholar 

  10. Kaufman BA, Park TS (1999) Ventricular anatomy and shunt catheters. Pediatr Neurosurg 31:1–6

    Article  PubMed  CAS  Google Scholar 

  11. Kellnar S, Boehm R, Ring E (1995) Ventriculoscopy-aided implantation of ventricular shunts in patients with hydrocephalus. J Pediatr Surg 30:1450–1451

    Article  PubMed  CAS  Google Scholar 

  12. Kestle JR, Drake JM, Cochrane DD, Milner R, Walker ML, Abbott R 3rd, Boop FA, Endoscopic Shunt Insertion Trial participants (2003) Lack of benefit of endoscopic ventriculoperitoneal shunt insertion: a multicenter randomized trial. J Neurosurg 98:284–290

    PubMed  Google Scholar 

  13. Kim YB, Lee JW, Lee KS, Lee KC (2006) Image-guided placement of ventricular shunt catheter. J Clin Neurosci 13:50–54

    Article  PubMed  Google Scholar 

  14. Krombach G, Ganser A, Fricke C, Rohde V, Reinges M, Gilsbach J, Spetzger U (2000) Virtual placement of frontal ventricular catheters using frameless neuronavigation: an “unbloody training” for young neurosurgeons. Minim Invasive Neurosurg 43:171–175

    Article  PubMed  CAS  Google Scholar 

  15. Krötz M, Linsenmaier U, Kanz KG, Pfeifer KJ, Mutschler W, Reiser M (2004) Evaluation of minimally invasive percutaneous CT-controlled ventriculostomy in patients with severe head trauma. Eur Radiol 14:227–233

    Article  PubMed  Google Scholar 

  16. Melada A, Heinrich Z, Chudy D, Scap M, Rotim K (2000) The difference between ultrasound-guided and stereotactic-guided neurosurgical procedures. Minim Invasive Neurosurg 43:149–152

    Article  PubMed  CAS  Google Scholar 

  17. Missori P, Artizzu S, Salvati M (2000) Immediate postoperative CT to assess the correct positioning of a ventricular catheter. Br J Neurosurg 14:44–45

    Article  PubMed  CAS  Google Scholar 

  18. O’Leary ST, Kole MK, Hoover DA, Hysell SE, Thomas A, Shaffrey CI (2000) Efficacy of the Ghajar guide revisited: a prospective study. J Neurosurg 92:801–803

    PubMed  CAS  Google Scholar 

  19. Pang D, Grabb PA (1994) Accurate placement of coronal ventricular catheter using stereotactic coordinate-guided free-hand passage. Technical note. J Neurosurg 80:750–755

    PubMed  CAS  Google Scholar 

  20. Paramore CG, Turner DA (1994) Relative risks of ventriculostomy infection and morbidity. Acta Neurochir (Wien) 127:79–84

    Article  CAS  Google Scholar 

  21. Ruchholtz S, Waydhas C, Müller A, Lewan UM, Nast-Kolb D, Euler E, Pfeiffer KJ, Schweiberer L (1998) Percutaneous computed tomographic-controlled ventriculostomy in severe traumatic brain injury. J Trauma 45:505–511

    PubMed  CAS  Google Scholar 

  22. Seeger W (1978) Atlas of topographical anatomy of the brain and surrounding structures. Springer, Berlin Heidelberg New York

    Google Scholar 

  23. Stangl AP, Meyer B, Zentner J, Schramm J (1998) Continuous external CSF drainage—a perpetual problem in neurosurgery. Surg Neurol 50:77–82

    Article  PubMed  CAS  Google Scholar 

  24. Strowitzki M, Moringlane JR, Steudel WI (2000) Ultrasound-based navigation during intracranial burr-hole procedures. Experience in a series of 100 cases. Surg Neurol 54:134–144

    Article  PubMed  CAS  Google Scholar 

  25. Strowitzki M, Schwerdtfeger K, Steudel WI (2001) Ultrasound-guided aspiration of brain abscesses through a single burr-hole. Minim Invasive Neurosurg 44:135–140

    Article  PubMed  CAS  Google Scholar 

  26. Theodosopoulos PV, Abosch A, McDermott MW (2001) Intraoperative fiber-optic endoscopy for ventricular catheter insertion. Can J Neurol Sci 28:56–60

    PubMed  CAS  Google Scholar 

  27. Tirakotai W, Riegel T, Sure U, Bozinov O, Hellwig D, Bertalanffy H (2004) Clinical application of neuro-navigation in a series of single burr-hole procedures. Zentralbl Neurochir 65:57–64

    Article  PubMed  CAS  Google Scholar 

  28. Tuli S, O’Hayon B, Drake J, Clarke M, Kestle J (1999) Change in ventricular size and effect of ventricular catheter placement in pediatric patients with shunted hydrocephalus. Neurosurgery 45:1329–1333

    Article  PubMed  CAS  Google Scholar 

  29. Ure BM, Holschneider AM (1997) Ventriculoscopic implantation of ventricular shunts in children with hydrocephalus. Eur J Pediatr Surg 7:299–300

    Article  PubMed  CAS  Google Scholar 

  30. Woodworth GF, McGirt MJ, Elfert P, Sciubba DM, Rigamonti D (2005) Frameless stereotactic ventricular shunt placement for idiopathic intracranial hypertension. Stereotact Funct Neurosurg 83:12–16

    Article  PubMed  Google Scholar 

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Funding

The authors do not have any commercial or other associations that might pose a conflict of interest in connection with the presented method.

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Authors and Affiliations

  1. Department of Neurosurgery, Saarland University Medical School, Kirrberger Str., 66421, Homburg, Saarland, Germany

    M. Strowitzki, Y. Komenda, R. Eymann & W. I. Steudel

Authors
  1. M. Strowitzki
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  2. Y. Komenda
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  3. R. Eymann
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  4. W. I. Steudel
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Correspondence to M. Strowitzki.

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Strowitzki, M., Komenda, Y., Eymann, R. et al. Accuracy of ultrasound-guided puncture of the ventricular system. Childs Nerv Syst 24, 65–69 (2008). https://doi.org/10.1007/s00381-007-0410-x

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  • DOI: https://doi.org/10.1007/s00381-007-0410-x

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