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What is a ventriculostomy?

A ventriculostomy (ventric) is a device that drains excess cerebrospinal fluid (CSF) from the head. It is also used to measure the pressure in the head called intracranial pressure (ICP). The system is made up of a small tube, drainage bag, and monitor. 

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Excess CSF and blood can build up in your head after brain surgery, a head injury, or a ruptured aneurysm. This can create extreme pressure on the brain. The fluid pushes against brain tissue and slows the blood flow. The brain needs good blood flow for a constant supply of oxygen and nutrients to work well. The ventric allows the healthcare team to drain off excess fluid. 

How is a ventriculostomy placed?

The doctor will place the ventric during surgery in the OR or in the ICU. It takes less than an hour and does not require general anesthesia. Pain medicine will be given if needed. A small area of the head will be shaved and cleaned. A cloth drape will be placed over the head to keep the area sterile. 

After numbing the scalp, the doctor will make a small hole in the top of your head. Then, a narrow plastic tube will be placed into the fluid filled space of the brain. This tube is connected to a drainage bag and monitor. The healthcare team will monitor the pressure in your head (ICP) and drain off excess CSF from the brain as needed. The tube will be held in place with some stitches. It may be covered with a dressing to keep it clean.

What can I expect?

Your nurse will:

  • Check the drain 

  • Monitor the pressure

  • Drain off any extra CSF

  • Adjust the position of the drain

  • Check the dressing for leakage and signs of infection

The nurse will ask you questions such as, stick out your tongue, hold up your arms and show your teeth. While these questions and exercises may seem silly, they all provide the nurse with information about the function of your brain. 

The doctor may draw fluid samples from the drain to send to the lab to test for infection. If you get an infection, the doctor will treat you with antibiotics.

Do not touch your ventric while it is in place. Touching it may cause it to fall out, lead to infection, bleeding, or excessive drainage of fluid. Always ask the nurse to help with moving around, problems with the dressing, or itching at the site. 

Do not allow visitors to adjust your position or touch your drain. Only the nurse or doctor may safely use your ventric. Never move the head of the bed up or down without help from the nurse. It could cause CSF to drain out of the head, causing a severe headache or other problems.

The nurse needs to clamp the drain and adjust the level of the ventric whenever the position of the head is changed.

The doctor will decide when it’s safe to take the ventric out. The doctor will remove the stitches and gently pull the tube out. A dressing will be placed over the site. The nurse will watch it for drainage and infection. A staple or two may be needed to keep the site from draining. 

Talk to your healthcare team. Ask questions and express concerns about the drain and healing.