External Ventricular Drainage: Symptoms, Classification, Diagnosis & Recovery

An external ventricular drain (EVD), also referred to as ventriculostomy or extra ventricular drain, is a neurosurgical device used to manage hydrocephalus and reduce elevated intracranial pressure caused by blockages in the normal flow of cerebrospinal fluid (CSF) within the brain.

The temporary drainage of cerebrospinal fluid (CSF) from the lateral ventricles of the brain or the lumbar area of the spine into an external collection bag is known as external drainage and monitoring. Using a mix of gravity and intracerebral pressure, an external ventricular drainage (EVD) system drains CSF. The rate of drainage is determined by the height of the EVD system in relation to the patient's anatomy.

In neurocritical care, EVDs are used to:

• Reduce high intracranial pressure (ICP)
• CSF (cerebrospinal fluid) that has become infectious should be drained
• After surgery or a hemorrhage, drain any crimson CSF or blood
• Keep an eye on the CSF flow rate
• Patients undergoing open TAA/TAAA repair surgery or who become symptomatic after surgery should have their CSF removed

Types of drainage used in EVD:

• Continuous drainage
• Intermittent drainage

Signs and symptoms indicating the need for External Ventricular Drainage (EVD) include:

• Elevated Intracranial Pressure (ICP) includes Symptoms such as severe headache, nausea, vomiting, and altered mental status.
• Hydrocephalus Symptoms are gait disturbances, difficulty with balance, urinary incontinence, and cognitive changes.
• Patients with severe head injuries or brain hemorrhages may require EVD to manage pressure and fluid buildup.
• Intracranial Bleeding such as sudden severe headache, changes in consciousness, or neurological deficits may necessitate EVD placement for monitoring and drainage.