A Modification of the Brown-Roberts-Wells Stereotactic Frame for Implantation of Ventricular Access Reservoirs

Abstract

Abstract A ventricular catheter and connected subcutaneous reservoir (ventricular access reservoir) allows easy, repeated access to the cerebrospinal fluid for a multitude of purposes. In situations in which the ventricles are small or displaced, insertion of a ventricular catheter may be difficult. Multiple passes to cannulate the ventricle may damage the brain and manipulation of the catheter and reservoir may cause migration of the catheter, possibly compromising its function. A stereotactic method for insertion of ventricular access reservoirs using a device that attaches to the Brown-Roberts-Wells stereotactic system has been developed. With this device the catheter and reservoir are guided into place as a single unit, utilizing a guide attached to the Brown-Roberts-Wells frame. This technique has been useful in inserting ventricular access reservoirs into patients with small ventricles or in whom there is some abnormality of the brain or skull that renders classical landmarks for ventricular cannulation useless.