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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Ultrasound guided implantation of ventricular catheters in premature infants – a technical note

Meeting Abstract

  • Ilker Y. Eyüpoglu - Neurochirurgische Klinik, Universitätsklinikum Erlangen, Deutschland
  • Michael Schroth - Kinder- und Jugendklinik, Universitätsklinikum Erlangen, Deutschland
  • Oliver Ganslandt - Neurochirurgische Klinik, Universitätsklinikum Erlangen, Deutschland
  • Wolfgang Rascher - Kinder- und Jugendklinik, Universitätsklinikum Erlangen, Deutschland
  • Michael Buchfelder - Neurochirurgische Klinik, Universitätsklinikum Erlangen, Deutschland
  • Jörg Jüngert - Kinder- und Jugendklinik, Universitätsklinikum Erlangen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1800

DOI: 10.3205/10dgnc271, URN: urn:nbn:de:0183-10dgnc2714

Published: September 16, 2010

© 2010 Eyüpoglu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: Modern pediatric intensive care enables survival of premature infants. These patients often require ventricular drainages for posthemorrhagic hydrocephalus. However, the exact insertion of a catheter for CSF drainage in premature infants is a challenge because of the small anatomical structures. Ultrasound guided catheter placement could be a simple method to overcome these problems. Here, we report our experience in 5 cases of ultrasound-guided catheter implantations.

Methods: Sonographic imaging was performed in 4 patients using an 8-MHz curved-array-probe. In a patient with a small fontanel, we used a 4-MHz sector-probe. 3 patients suffered from a post hemorrhagic hydrocephalus, one patient from a Chiari malformation. 3 of the premature infants weighed about 700 grams, whereas one weighed 1,300 grams. In one case the patient was 6 months old, but an optimal catheter positioning was necessary for subsequent intrathecal chemotherapy.

Results: Correct catheter implantation was possible in all cases. A pitfall was a too small working area. In order to have an adequate acoustic window, the fontanel must be included into the depicted sterile area. A fundamental aspect is the prior sonographic determination of the length of the catheter. This was possible in all cases.

Conclusions: Especially in cases of premature infants with hydrocephalus, implantation of ventricular catheters under ultrasound navigation represents a substantial advantage. A malpositioning of the catheter may be immediately corrected or avoided. Even with more specific indications, i.e. catheter implantation for intrathecal chemotherapy the intraoperative ultrasound control is not essential but helpful.