Ventriculostomy is a neurosurgical procedure that involves creating a hole (stoma) within a cerebral ventricle for drainage. It is done by surgically penetrating the skull, dura mater, and brain such that the ventricle of the brain is accessed. When catheter drainage is temporary, it is commonly referred to as an external ventricular drain, or EVD.
When catheter drainage is permanent, it is usually referred to as a shunt. There are many catheter-based ventricular shunts that are named for where they terminate, for example, a ventriculoperitoneal shunt terminates in the peritoneal cavity, a ventriculoatrial shunt terminates within the atrium of the heart, etc. The most common entry point on the skull is called Kocher's point, which is measured 11 cm posterior to the nasion and 3 cm lateral to the midline. EVD ventriculostomy is done primarily to monitor the intracranial pressure as well as to drain cerebrospinal fluid (“CSF”), primarily, or blood to relieve pressure from the central nervous system (CNS).
Strictly speaking, “ventriculostomy” does not require the use of tubing. For example, a “third ventriculostomy” is a neurosurgical procedure that creates a hole in the floor of the third ventricle and usually has no indwelling objects.
Ventriculostomy is one of the most common emergency based neurosurgical procedures practitioners undertake globally.
On 15th October 1744, the French surgeon Claude-Nicolas Le Cat (1700-1768) introduced a specially invented cannula into the lateral ventricle of a newborn boy with hydrocephalus. The cannula was used as a tap and was left in place for 5 days, until the death of the child. This procedure should be seen as the first documented description of a device for repeated ventricular taps in the treatment of hydrocephalus. 1).