External ventricular drain complications in neurosurgery patients: A systematic review

Introduction: External ventricular drains (EVD) represent one of the most prevalent neurosurgical procedures, providing treatment of elevated intracranial pressure while also enabling real-time intracranial pressure monitoring. However, the incidence of complications is increasing, with the rate of EVD-associated hemorrhage alone ranging up to 41%. Additional complications, including misplacement, dislodgment, blockage and infection, brain abscess and subdural empyema, have also been vastly reported in neurosurgery patients.
Aims: The aim of this systematic review was to provide an updated assessment of the current literature regarding EVD complications in neurosurgery patients.
Methods: A thorough search strategy was conducted in accordance with the PRISMA guidelines, with the scope of literature being obtained from the literature databases PubMed, Scopus, and Web of Science. Once duplicates had been removed, the remaining citations were screened against the inclusion and exclusion criteria to ensure only relevant material was included in this systematic review.
Results: The search strategy identified 12 articles that discussed the incidence and risk factors of EVD complications in neurosurgery patients. Several complications were established, including aneurysm re-bleeding, hemorrhage, meningitis, and EVD-related infection. The literature also highlighted the vast number of risk factors to these complications, including fluctuations in serum sodium levels. No contradictions were apparent within the literature.
Conclusion: The incidence of EVD complications in neurosurgery patients is a cause for concern. Identifying potential risk factors in these patients is crucial in minimizing the likelihood of adverse events.