Abstract： Objective To study the accuracy of the barehanded technique for frontal ventricular catheter ization.Methods Retrospective evaluation was performed on the head computed tomography (CT) scans of 130 patients who underwent 146 barehanded ventricular catheterizations in this hospital. Among all the patients, ventriculoperitoneal/ventriculoatrial shunts were performed in 98 patients and eatra ventricular drain ages(EVD) in 32 patients. To evaluate catheter tip position, we used a modified Kakarla grading system: grade 1, optimal placement in the ipsilateral frontal angle, just in front of the foramen of Monro; grade 2, functional placement in the lateral ventricle except ipsilateral frontal angle, or third ventricle; and grade 3, suboptimal placement in the cerebral parenchyma or nontarget cerebrospinal fluid space, with or without functional drainage. Results The mean age of the patients was (44.91±20.5) years (age range, 2.5-78 years).There were 45 (30.8%) grade 1, 85(58.2%)grade 2, and 16 (11.0%)grade 3 catheterizations. Conclusions The results of this study have shown that only 30.8% catheter tips were in ideal target position, and 11.0% of these catheter tips were placed in nonventricular spaces. We consider that barehanded ventricular catheterization may be an inaccurate procedure, and there is certainly much room for improvement. The development of an easy to use, portable, image-guided system may guarantee accuracy of ventricular catheterizations .
2012, Vol. 23 
