A Review of EVD Utilization in 400 Patients Admitted to a Single Institution over a 3-Year Period with Aneurysmal Subarachnoid Haemorrhage

Objectives: This is a review of the complications associated with external ventricular drainage (EVD) in patients presenting to a single institution with aneurysmal subarachnoid hemorrhage (SAH) over a 3-year period.

Design: The patients were identified from a comprehensive neurovascular database of all patients presenting with aneurysmal SAH. A retrospective analysis of case notes and imaging studies was then performed. Specific complications reviewed were rates of, and risk factors for, rebleed, infection, blockage and reinsertion, and malposition requiring resiting of the drain or directly resulting in neurological deficit.

Subjects: Total of 400 patients presenting with aneurysmal SAH over the 3-year period were identified. Of these, 60 underwent cerebrospinal fluid (CSF) diversion by EVD insertion only.

Methods: Medical records and imaging studies were retrospectively analyzed.

Results: Despite the perceived risk associated with EVD insertion, no patient from the cohort receiving an EVD suffered a rebleed as a direct result. Infection rates associated with EVD insertion was found to be low (<5%) as indeed were the rates of EVD blockage. There were no cases of neurological deterioration as a direct result of EVD malposition.

Conclusions: EVD can be regarded as a safe and effective method of CSF diversion in patients presenting with aneurysmal SAH.