Explaining the top common problems of ventriculocentesis

  Anterior horn puncture (2.52.5, 2.5, 3, no more than 5) The right anterior horn is usually taken, with 2.5 cm next to the midline and 2 cm inside the hairline (2.5); or 2.5 cm next to the midline and 2.5 cm in front of the coronal suture as the puncture point, with a skin incision 3 cm long; parallel to the sagittal plane, aligned with the midpoint of the hypothetical line connecting the two external auditory canals; generally entering 5 cm or entering no more than 5 cm deep to prevent being The choroid plexus is blocked. A silicone tube or an 8-gauge catheter is placed.  Posterior horn puncture (6, 3, 3, no more than 6 or 5, 3, 3, no more than 5) The right posterior horn is usually taken, 5-6 cm above the external occipital ridge as the puncture point, 3 cm next to the midline, with a skin incision 3 cm long; parallel to the sagittal plane, aligned with the plane of the ipsilateral orbital crest; usually 5-6 cm or no more than 5-6 cm deep to prevent blockage by the choroid plexus. A silicone tube or an 8-gauge catheter is placed.  Puncture of the lateral ventricular triangle 4 cm above and 4 cm behind the external auditory foramen, with a vertical entry depth of about 4-5 cm. Indications: Removal of blood accumulation in the ventricular system, treatment and prevention of acute obstructive hydrocephalus/central hyperthermia/ventricular reaction and other serious complications due to blood accumulation in the ventricular system; also bilateral ventricular drainage and counter-oral irrigation. For example, our department often performs: lateral ventricular hemorrhage casts; hemorrhage in the thalamus or basal ganglia region breaking into the lateral ventricles; cerebellar hemorrhage breaking into the fourth ventricle; brainstem hemorrhage resulting in impaired cerebrospinal fluid circulation.  Precautions: When diffuse brain swelling or cerebral edema causes normal or shrunken ventricles, try not to puncture; puncture is difficult and drainage is also difficult; try not to puncture when the midline is severely deviated or reposition according to the results of head CT at that time when the midline is mildly deviated; pay attention to postural drainage and closed tube test for 24 hours; sudden transitional decompression is strictly prohibited at the initial stage, and cerebrospinal fluid should be released gradually; the cranial cone should be drilled through the dura in case the brain needle cannot be passed to cause dural traction Epidural hematoma.