Stopping CSF leaks at external ventricular drain exit sites: a technical note

Abstract

Cerebrospinal fluid (CSF) leak is a major risk factor for external ventricular drain infection. Here, we present a surgical technique to reduce the possibility of CSF leak at the external ventricular drain (EVD) exit site in high-risk patients. Vertical mattress sutures are placed circumferentially around the EVD catheter tract as it passes under the skin, so to close off the tract along which CSF may travel toward the exit site. Specific case examples are discussed where the introduction of this technique was found to be helpful in stopping exit-site CSF leak. In our experience, these surgical steps are useful adjuncts that should be considered in all high-risk patients undergoing EVD placement.