I. Indications.
1.Diagnostic puncture
(1) Ventriculography;
(2) Collection of cerebrospinal fluid specimens for laboratory tests;
(3) To identify the type of hydrocephalus.
That is, a double ventricular and lumbar puncture is performed and a dye is used to test whether the two are connected.
If the dye can appear in the CSF of the lumbar puncture, it indicates that the hydrocephalus is communicative, and vice versa is obstructive.
2. Therapeutic puncture.
(1) Temporary ventricular drainage to temporarily relieve intracranial pressure, especially for occipital foramen magnum hernia is an emergency measure.
(2) Used to reduce intracranial pressure during or after craniotomy.
(3) Intracerebroventricular injection of drugs to treat intracranial infections (or subarachnoid metastases of malignant tumors, especially leukemia).
(4) Intracerebroventricular stasis with urgent need for removal.
(5) To perform cerebrospinal fluid shunt surgery and place various shunt catheters.
II. Contraindication signs.
(1) Obvious infection at the puncture site
(2) When there is a vascular malformation of the cerebral hemisphere or a tumor with rich blood supply
(3) Ventricular puncture must be performed with great caution. In cases of subarachnoid hemorrhage, ventricular puncture is generally not performed except for emergency treatment because the source of the hemorrhage is unknown and in order to avoid puncture injury causing hemorrhage and pathogenic tissue.
(4) Ventricular puncture is contraindicated in patients with obvious bleeding tendencies
(5) Extensive cerebral edema and narrow ventricles;
Third, the operation method and application range.
1.Frontal entry method (puncturing the anterior horn of the lateral ventricle): commonly used
(1) Application range: commonly used for ventriculography and emergency drainage.
(2) Method: supine position
(3)Puncture point: 2-2.5cm on the hairline and parasternal opening on the midline; or 1cm before the coronal suture and .2.5cm parasternal opening on the midline, or 2cm inside the hairline or before the coronal suture and 3cm parasternal opening on the midline.
Balding patients: 8-10 cm above the arch of the eyebrow, 2.5 cm paracentral opening.