{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:32:57Z","timestamp":1783776777155,"version":"3.55.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2015,12]]},"abstract":"\nOBJECT<\/jats:title>\nExternal ventricular drains (EVDs) are regularly used in pediatric neurosurgery for diagnostic and therapeutic purposes. Hemorrhage caused by placing an EVD is a common complication noted in the adult literature. In the pediatric literature, on the other hand, only a few articles have assessed the risk of hemorrhage with placement, and none have reported the occurrence of hemorrhage with removal of an EVD. The authors investigated the incidence of hemorrhage with both placement and removal of the EVD in a pediatric population.<\/jats:p><\/jats:sec>\n\nMETHODS<\/jats:title>\nAfter obtaining institutional review board approval, a comprehensive database was created to include all pediatric patients who required EVD placement between March 2008 and June 2014 at the authors\u2019 institution. A retrospective chart review was completed, and all imaging was reviewed for evidence of hemorrhage with placement and removal of the EVD.<\/jats:p><\/jats:sec>\n\nRESULTS<\/jats:title>\nDuring the designated time period, 73 EVDs were placed in 63 patients (ages 2 weeks\u201317 years). Indications for EVD placement were as follows: shunt infection\/malfunction (21), tumor (12), hydrocephalus (18), hemorrhage (12), edema (4), trauma (1), and other (5). Hemorrhage with placement was noted in 5 of the 50 patients who underwent imaging, with a volume ranging from 0.48 cm3<\/jats:sup> to 7.7 cm3<\/jats:sup>. Thirty-two patients had imaging after EVD removal, and 7 of these patients were noted to have hemorrhage (volume range 0.012 cm3<\/jats:sup> to 81.5 cm3<\/jats:sup>).<\/jats:p><\/jats:sec>\n\nCONCLUSIONS<\/jats:title>\nThe authors found the incidence of hemorrhage at EVD placement to be 10%, and the incidence of hemorrhage on EVD removal to be 21.9% in those patients who underwent imaging after each event. Although none of the hemorrhages were of obvious clinical significance, these data can be useful in decision making, and in discussing the risks of EVDs with the patient\u2019s family.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.5.peds1563","type":"journal-article","created":{"date-parts":[[2015,9,18]],"date-time":"2015-09-18T13:59:13Z","timestamp":1442584753000},"page":"662-667","source":"Crossref","is-referenced-by-count":16,"title":["Incidence of hemorrhage in the pediatric population with placement and removal of external ventricular drains"],"prefix":"10.3171","volume":"16","author":[{"given":"Catherine","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Guillaume","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1 Suppl","key":"b1-peds1563","series-title":"J Neurosurg","first-page":"53","article-title":"Complications of intracranial pressure monitoring in children with head trauma","volume":"101","author":"Anderson","year":"2004"},{"key":"b2-peds1563","series-title":"Eur J Paediatr Neurol","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1016\/j.ejpn.2012.04.002","article-title":"Timing of external ventricular drainage and neuro-developmental outcome in preterm infants with posthemorrhagic hydrocephalus","volume":"16","author":"Bassan","year":"2012"},{"key":"b3-peds1563","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1007\/s003810050022","article-title":"Long-term experience with subcutaneously tunneled external ventricular drainage in preterm infants","volume":"16","author":"Berger","year":"2000"},{"key":"b4-peds1563","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1159\/000070877","article-title":"Hemorrhagic complications of intracranial pressure monitors in children","volume":"39","author":"Blaha","year":"2003"},{"key":"b5-peds1563","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1007\/s003810050102","article-title":"Use of external drainage for posthemorrhagic hydrocephalus in very low birth weight premature infants","volume":"13","author":"Cornips","year":"1997"},{"key":"b6-peds1563","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/s00234-003-0995-z","article-title":"Diffusion-weighted imaging provides support for secondary neuronal damage from intraparenchymal hematoma","volume":"45","author":"Forbes","year":"2003"},{"key":"b7-peds1563","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.3171\/2008.9.JNS17661","article-title":"Hemorrhage rates after external ventricular drain placement","volume":"110","author":"Gardner","year":"2009"},{"key":"b8-peds1563","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"766","DOI":"10.3171\/jns.1981.55.5.0766","article-title":"External ventricular drainage for control of posthemorrhagic hydrocephalus in premature infants","volume":"55","author":"Harbaugh","year":"1981"},{"key":"b9-peds1563","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1007\/s003810000363","article-title":"Primary intervention for posthemorrhagic hydrocephalus in very low birthweight infants by ventriculostomy","volume":"17","author":"Heep","year":"2001"},{"key":"b10-peds1563","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1007\/s00381-011-1413-1","article-title":"Posthemorrhagic hydrocephalus in very low birth weight infants\u2014-a new gentle surgical technique for external ventricular drainage","volume":"27","author":"Januschek","year":"2011"},{"key":"b11-peds1563","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1007\/s00381-004-1080-6","article-title":"External ventricular drains: is there a time limit in children?","volume":"21","author":"Khalil","year":"2005"},{"key":"b12-peds1563","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1161\/01.STR.27.8.1304","article-title":"The ABCs of measuring intracerebral hemorrhage volumes","volume":"27","author":"Kothari","year":"1996"},{"key":"b13-peds1563","series-title":"Am J Dis Child","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1001\/archpedi.1984.02140450015005","article-title":"Rapidly progressive posthemorrhagic hydrocephalus. Treatment with external ventricular drainage","volume":"138","author":"Kreusser","year":"1984"},{"key":"b14-peds1563","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.3171\/2010.9.JNS10445","article-title":"Risk of ventriculostomy-related hemorrhage in patients with acutely ruptured aneurysms treated using stent-assisted coiling","volume":"114","author":"Kung","year":"2011"},{"key":"b15-peds1563","series-title":"Minerva Anestesiol","first-page":"663","article-title":"Results of early external ventricular diversion in posthemorrhagic ventricular dilatation in the newborn","volume":"60","author":"Massone","year":"1994"},{"key":"b16-peds1563","series-title":"Pediatr Crit Care Med","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1097\/PCC.0b013e3181a320cd","article-title":"External ventricular drains in pediatric patients","volume":"10","author":"Ngo","year":"2009"},{"key":"b17-peds1563","series-title":"Pediatr 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