Cervical subarachnoid catheter placement for continuous cerebrospinal fluid drainage: A safe and efficacious alternative to the classic lumbar cistern drain

Hamad I. Farhat, Mohamed Samy Elhammady, Allan D. Levi, Mohammad Ali Aziz-Sultan

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

BACKGROUND: Cerebrospinal fluid (CSF) drainage serves an important role in the management of patients with established or potential CSF fistulae. Classically, a lumbar CSF drain has been used for this purpose and has been shown to be safe and effective. In certain cases, such as extensive previous lumbar surgery, a lumbar drain cannot be used. In such instances, a cervical CSF drain can be inserted via a lateral C1-2 puncture and provides an excellent and safe alternative. OBJECTIVE: To describe the technique, safety, and effectiveness of placing a cervical drain for CSF drainage. Pitfalls and possible complications and their avoidance are also discussed. METHODS: Twenty-seven cervical drains were placed in 24 patients with a mean age of 56.1 years (range, 19-82 years). There were 13 women and 11 men. All cervical drains were placed via a lateral C1-2 puncture under direct fluoroscopic vision. A standard Hermetic closed-tip lumbar catheter was used in all cases. The drains were in place for an average of 5.96 days (range, 3-11 days). CSF surveillance was performed on the day of placement as well as every 48 hours that the drain was in place. RESULTS: Cervical drain placement was achieved in all cases, allowing for continuous CSF drainage. No permanent procedural complications occurred. There were no instances of meningitis. CONCLUSIONS: Placement of a cervical intrathecal catheter for CSF drainage is a safe and effective alternative when lumbar access is contraindicated or not achievable.

Original languageEnglish (US)
Pages (from-to)ons52-ons56
JournalNeurosurgery
Volume68
Issue numberSUPPL. 1
DOIs
StatePublished - Mar 1 2011

Keywords

  • Cerebrospinal fluid
  • Cervical drain
  • Fluoroscopy
  • Lateral C1-2 puncture

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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