Technical note: external cerebrospinal fluid (CSF) drainage by percutaneous needle punction in newborn children

Abstract

External drainage of CSF in children is indicated in acute hydrocephalus e.g. after intraventricular bleeding or infection. In these cases the drainage has to remain in place until physiological CSF circulation is restored or an internal shunt can be inserted. External drainage is mostly performed using a silicon catheter connected to a plastic bag. An external CSF drainage left for several days in situ bears an increasing risk of bacterial infection. In these cases a metal needle minimizes the risk of ventriculitis. For prevention of accompanying infection we implanted a Cytocan port needle with a 20 G diameter in 7 infants. The needle is easily inserted with low risk of complications. By its plastic top angulated at 90 degrees to the needle the system can be fixed to the skin very safely by suture or tape. With this system neither an implantation related intracerebral haemorrhage nor an accompanying ventriculitis was encountered. In two cases a pre-existing ventriculitis was cured by this needle drainage and antibiotic treatment. In five cases an acute hydrocephalus after intraventricular haemorrhage was drained by the port needle system.