Use of frameless neuronavigation for bedside placement of external ventricular catheters.

Neuronavigation for placement of ventricular catheters has been described. At our institution, electromagnetic neuronavigation is frequently utilized for difficult ventricular catheter placement. In patients who develop a trapped ventricle as a result of an intraparenchymal or intraventricular mass lesion, successful catheter placement may be difficult, as the location and trajectory are unfamiliar. The authors report their experience using electromagnetic neuronavigation for bedside placement of external ventricular catheters in patients with trapped ventricles. The technique for bedside placement of external ventricular catheters utilizing electromagnetic neuronavigation is reviewed. The benefits of this technique and those patients in whom it may be most useful are discussed. Utilization of bedside electromagnetic neuronavigation for placement of difficult external ventricular catheters into trapped ventricles is an option for accurate navigated catheter placement. Bedside electromagnetic neuronavigation offers accurate catheter placement in awake patients. This technique may be utilized in patients with high perioperative risk factors as it does not require general anesthesia. The procedure is well tolerated as it does not require rigid head fixation.