Rate of external ventricular drain malposition.

G Narenthiran, BD White. Department of Neurosurgery, Queen’s Medical Centre, Nottingham, UK
g_narenthiran@hotmail.com

The aim was to ascertain the rate of malposition of external ventricular drain (EVD) in our centre. The policy of our unit is to undertake insertion of EVDs in our operating theatres (i.e. as opposed to in intensive care units). We checked the operation log-book of our operating theatres for a 1 year period (14 February 2003 - 13 February 2004) to find out i. the number of EVDs inserted and ii. the number patients who had insertion of more than one EVD. Then we checked the notes and imaging studies of the patient to check for the reason for the repeated insertion of EVDs. Over that 1 year period 84 patients had insertion of EVD (frontal, parietal and occipital) and 13 of them had more than one EVD; 8 of the 13 were for malposition of EVD (as ascertained from the notes or from computed tomography (CT) of head). Therefore there was a minimum of 9.5% complication from malpostion of EVD with a minimum complication rate for insertion of EVD being 15.5% The often quoted value for complication for EVD insertion is as ‘around 3%’. Findings from our study illustrates the need for audit of basic neurosurgery procedures and to quote ‘in-house’ values of complication than those published by other centres.

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