MD128Y - Device and method for drainage of ventricle of brain - Google Patents

Device and method for drainage of ventricle of brain Download PDF

Info

Publication number
MD128Y
MD128Y MDS20090093A MDS20090093A MD128Y MD 128 Y MD128 Y MD 128Y MD S20090093 A MDS20090093 A MD S20090093A MD S20090093 A MDS20090093 A MD S20090093A MD 128 Y MD128 Y MD 128Y
Authority
MD
Moldova
Prior art keywords
tube
drainage
ventricle
cerebral
distal end
Prior art date
Application number
MDS20090093A
Other languages
Romanian (ro)
Inventor
Dan Lisii
Valeriu Timirgaz
Grigore Zapuhlih
Original Assignee
Universitatea De Stat De Medicina Si Farmacie "Nicolae Testemitanu" Din Republica Moldova
Imsp Institutul De Neurologie Si Neurochirurgie
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Universitatea De Stat De Medicina Si Farmacie "Nicolae Testemitanu" Din Republica Moldova, Imsp Institutul De Neurologie Si Neurochirurgie filed Critical Universitatea De Stat De Medicina Si Farmacie "Nicolae Testemitanu" Din Republica Moldova
Priority to MDS20090093A priority Critical patent/MD128Z/en
Publication of MD128Y publication Critical patent/MD128Y/en
Publication of MD128Z publication Critical patent/MD128Z/en

Links

Landscapes

  • External Artificial Organs (AREA)

Abstract

The invention relates to medicine, in particular neurosurgery and may be used for the treatment of acute hydrocephalus and of primary and secondary intracranial pressure. The device for drainage of ventricle of brain comprises an elastic tube with drain holes and with blind distal end, on the proximal part of the tube it is put on a jacket, and the proximal end of the tube is connected to a branch, inside the tube it is installed an elastic tube with the diameter 2...3 times smaller, the distal end of which is connected to one of the branch connections. The method for drainage of ventricle of brain consists in that it is carried out the cerebral trepanation in the frontal precoronary region, it is introduced the device according to the invention with the blind end into the cavity of ventricle and it is carried out the passive evacuation of the cerebrospinal fluid concomitantly with the permanent irrigation by introduction into the tube with the smaller diameter of the physiologic saline, a liquid similar to the cerebrospinal liquid or an antibacterial preparation.

Description

Invenţia se referă la medicină, în special la neurochirurgie şi poate fi utilizată pentru tratamentul hidrocefaliei acute şi hipertensiunii intracraniene primare sau secundare. The invention relates to medicine, in particular to neurosurgery and can be used for the treatment of acute hydrocephalus and primary or secondary intracranial hypertension.

Este cunoscut un dispozitiv pentru drenarea ventriculelor cerebrale în hidrocefalii acute şi hipertensiuni intracraniene, care reprezintă un tub din silicon cu orificii de drenare conectat la un sistem închis de evacuare şi colectare a lichidului cerebrospinal [1]. A device for draining the cerebral ventricles in acute hydrocephalus and intracranial hypertension is known, which is a silicone tube with drainage holes connected to a closed system for draining and collecting cerebrospinal fluid [1].

Dezavantajele dispozitivului menţionat constau în prezenţa riscului înalt al infectării drenajului, cât şi în disfuncţia şuntului cauzat de obstrucţia cu depuneri de fibrină şi cheaguri de sânge. The disadvantages of the mentioned device consist in the presence of a high risk of infection of the drainage, as well as in shunt dysfunction caused by obstruction with fibrin deposits and blood clots.

Este cunoscută o metodă de tratament a hidrocefaliei pronunţate obstructive şi a hipertensiunii intracraniene prin aplicarea drenajului ventricular extern temporar, care constă în aceea că se efectuează trepanarea cerebrală în regiunea frontală precoronară, se introduce dispozitivul de drenaj pe un mandren în cavitatea ventriculului. După verificarea funcţionării, drenajul este exteriorizat printr-un tunel subcutanat şi conectat la un sistem închis de colectare. Lichidul sub presiune este colectat într-o pungă sterilă printr-un sistem închis cuplat la un dispozitiv de măsurare a tensiunii intracraniene. Dispozitivul de drenare se menţine până la rezolvarea stării patologice [2]. A method of treating severe obstructive hydrocephalus and intracranial hypertension by applying temporary external ventricular drainage is known, which consists in performing cerebral trepanation in the precoronary frontal region, inserting the drainage device on a mandrel into the ventricular cavity. After checking its functioning, the drainage is externalized through a subcutaneous tunnel and connected to a closed collection system. The pressurized fluid is collected in a sterile bag through a closed system coupled to a device for measuring intracranial pressure. The drainage device is maintained until the pathological condition resolves [2].

Această metodă este larg răspândită şi reprezintă standardul de bază în urgenţele neurochirurgicale pentru a evita angajarea crierului şi riscul iminent de deces al pacientului cu hidrocefalie pronunţată şi hipertensiune intracraniană. This method is widespread and represents the basic standard in neurosurgical emergencies to avoid brain involvement and the imminent risk of death of the patient with pronounced hydrocephalus and intracranial hypertension.

Dezavantajul acestei metode constă în riscul dezvoltării unor complicaţii infecţioase, şi anume a ventriculitei, a meningitei secundare etc. Rata infecţiei legate de drenajul ventricular extern este de 10% în prima zi şi creşte exponenţial la 70% în următoarele 3…4 zile. The disadvantage of this method is the risk of developing infectious complications, namely ventriculitis, secondary meningitis, etc. The infection rate related to external ventricular drainage is 10% on the first day and increases exponentially to 70% in the next 3…4 days.

Problema pe care o rezolvă invenţia constă în lărgirea gamei dispozitivelor de drenare şi a metodelor de drenare a ventriculelor care ar preveni complicaţiile precoce şi tardive. The problem that the invention solves consists in expanding the range of drainage devices and methods of draining the ventricles that would prevent early and late complications.

Problema invenţiei se soluţionează prin în aceea ca dispozitivul de drenare a ventriculelor cerebrale conţine un tub elastic cu orificii de drenare şi cu capătul distal orb, pe partea proximală a tubului este îmbrăcat un manşon, iar capătul proximal al tubului este unit la un racord, în interiorul tubului este amplasat un tub elastic cu diametrul de 2…3 ori mai mic, capătul distal al căruia este unit la una din conexiunile racordului. The problem of the invention is solved by the fact that the cerebral ventricle drainage device contains an elastic tube with drainage holes and a blind distal end, a sleeve is worn on the proximal part of the tube, and the proximal end of the tube is connected to a connector, an elastic tube with a diameter 2...3 times smaller is placed inside the tube, the distal end of which is connected to one of the connector connections.

Se revendică totodată şi o metodă de drenare a ventriculelor cerebrale, care constă în aceea că se efectuează trepanarea cerebrală în regiunea frontală precoronară, se introduce dispozitivul menţionat cu capătul orb în cavitatea ventriculului şi se efectuează evacuarea pasivă a lichidului cerebrospinal concomitent cu irigarea continuă prin introducerea în tubul cu diametrul mai mic a serului fiziologic, unui lichid similar lichidului cerebrospinal sau unui preparat antibacterian. A method of draining the cerebral ventricles is also claimed, which consists in performing cerebral trepanation in the precoronary frontal region, inserting the aforementioned device with the blind end into the ventricle cavity and performing passive evacuation of the cerebrospinal fluid simultaneously with continuous irrigation by introducing physiological saline, a liquid similar to cerebrospinal fluid or an antibacterial preparation into the tube with a smaller diameter.

Dispozitivul şi metoda revendicată prezintă o serie de avantaje faţă de soluţiile apropiate: prevenirea infecţiei secundare, prevenirea obstrucţiei drenajului, şi deci necesitatea reviziei sau schimbului drenajului, posibilitatea aplicării acestei metode şi în caz de meningită, menţinerea şuntului pe o perioadă îndelungată. The claimed device and method present a series of advantages over similar solutions: prevention of secondary infection, prevention of drainage obstruction, and therefore the need for revision or replacement of the drainage, possibility of applying this method also in case of meningitis, maintenance of the shunt for a long period.

Rezultatul obţinut constă în lărgirea gamei dispozitivelor de drenare şi a metodelor de drenare a ventriculelor care previn eficient complicaţiile precoce şi tardive. The result obtained consists in expanding the range of drainage devices and ventricular drainage methods that effectively prevent early and late complications.

Invenţia se explică prin figura care reprezintă: aspectul general al dispozitivului de drenare a ventriculelor cerebrale, care constă dintr-un tub elastic 1, cu orificii de drenare 3 şi cu capătul distal orb. Pe partea proximală a tubului 1 este îmbrăcat un manşon 4, iar capătul proximal al tubului este unit la un racord 5, în interiorul tubului este amplasat un tub elastic 2 cu diametrul de 2…3 ori mai mic, capătul distal al căruia este unit la una din conexiunile racordului 5. The invention is explained by the figure which represents: the general appearance of the device for draining the cerebral ventricles, which consists of an elastic tube 1, with drainage holes 3 and a blind distal end. A sleeve 4 is worn on the proximal part of the tube 1, and the proximal end of the tube is connected to a connection 5, inside the tube is placed an elastic tube 2 with a diameter 2…3 times smaller, the distal end of which is connected to one of the connections of the connection 5.

Metoda de drenare a ventriculelor cerebrale constă în aceea că se efectuează trepanarea cerebrală în regiunea frontală precoronară, se introduce dispozitivul conform invenţiei cu capătul orb în cavitatea ventriculului şi se efectuează evacuarea pasivă a lichidului cerebrospinal concomitent cu irigarea continuă prin introducerea în tubul cu diametrul mai mic a serului fiziologic, unui lichid similar lichidului cerebrospinal sau unui preparat antibacterian. The method of draining the cerebral ventricles consists in performing cerebral trepanation in the precoronary frontal region, inserting the device according to the invention with the blind end into the ventricle cavity and performing passive evacuation of the cerebrospinal fluid simultaneously with continuous irrigation by introducing physiological saline, a liquid similar to cerebrospinal fluid or an antibacterial preparation into the tube with a smaller diameter.

Exemplu de realizare a invenţiei. Example of embodiment of the invention.

Pacientul B, 64 de ani, acuza cefalee pronunţată, instalată de 2 zile, cefaleea nu a cedat la administrarea analgezicilor, s-a constatat agravarea stării generale a pacientului şi apariţia somnolenţei. Pacientul intră dificil în contact, prezintă confuzie, pierderi de memorie. Din antecedente s-a constatat tabagism. La internare a fost efectuată tomografia coputerizată (TC) cerebrală, care pune în evidenţă o hemoragie în cisternele subarahnoidiene, dilatarea sistemului ventricular, edem periependimar. Examenul fundului de ochi pune în evidenţă un edem papilar bilateral. Diagnosticul stabilit a fost: Hemoragie subarahnoidiană, Hunt şi Hess 3, Fisher 2, Hidrocefalie acută. Hipertensiune intracraniană. Statutul neurologic Glasgow 12. Patient B, 64 years old, complained of a severe headache, which had been present for 2 days, the headache did not subside with the administration of analgesics, the patient's general condition worsened and drowsiness appeared. The patient has difficulty making contact, presents confusion, memory loss. A history of smoking was noted. Upon admission, a cerebral computed tomography (CT) scan was performed, which revealed a hemorrhage in the subarachnoid cisterns, dilation of the ventricular system, and periependymal edema. The fundus examination revealed bilateral papillary edema. The established diagnosis was: Subarachnoid hemorrhage, Hunt and Hess 3, Fisher 2, Acute hydrocephalus. Intracranial hypertension. Glasgow neurological status 12.

Evoluţia în dinamică a pacientului cu agravare a stării neurologice cu 3 puncte după scara Glasgow. A fost luată decizia de a efectua drenarea ventriculelor cerebrale în regim de urgenţă, conform metodei propuse şi cu dispozitivul revendicat. Pentru irigarea continuă a fost utilizată soluţia Ringher şi o soluţie de Amicacină. Nivelul de reglaj al presiunii intracraniene a fost stabilit la 18 mm ai coloanei de mercur. În total au fost evacuate pe parcursul a 7 zile 2000 mL de lichid. Înlăturarea drenajului a fost realizată după ce s-a făcut TC cerebrală de control, cât şi închiderea drenajului pentru mai mult de 24 de ore. Pe toată durata funcţionării dispozitivului de drenare au fost realizate analize repetate ale lichidului cerebral evacuat pentru a monitoriza debutul unei eventuale infecţii. Analizele bacteriologice efectuate după utilizarea dispozitivului au fost negative. Realizarea invenţiei s-a efectuat la Catedra de Neurochirurgie a Universităţii „N. Testemiţanu” şi Laboratorul de Neurochirurgie a INN. The dynamic evolution of the patient with worsening neurological condition by 3 points according to the Glasgow scale. The decision was made to perform emergency drainage of the cerebral ventricles, according to the proposed method and with the claimed device. Ringher solution and an Amikacin solution were used for continuous irrigation. The intracranial pressure adjustment level was set at 18 mm of mercury. In total, 2000 mL of fluid were evacuated over 7 days. The drainage was removed after a control cerebral CT scan was performed, as well as the drainage was closed for more than 24 hours. Throughout the operation of the drainage device, repeated analyses of the evacuated cerebral fluid were performed to monitor the onset of a possible infection. Bacteriological analyses performed after using the device were negative. The invention was implemented at the Department of Neurosurgery of the University "N. Testemiţanu” and the Neurosurgery Laboratory of INN.

1. Bronne V., Aschoff A., Hund E., Hampl J., Kunze S. Comercial external ventricular drainage sets: unsolved safety and handling problems. Acta Neurochir (Wien) 1991, 110, p. 49-56. 1. Bronne V., Aschoff A., Hund E., Hampl J., Kunze S. Commercial external ventricular drainage sets: unsolved safety and handling problems. Acta Neurochir (Wien) 1991, 110, p. 49-56.

2. Infection in Neurosurgery Working Party of the Britisch Society for Antimicrobial Chemotherapy: The management of neurosurgical patients with postoperative bacterial or aseptic meningitis or external ventricular drain-associated ventriculitis. Br. J. Neurosurg, 2000, 14, p.7-12. 2. Infection in Neurosurgery Working Party of the British Society for Antimicrobial Chemotherapy: The management of neurosurgical patients with postoperative bacterial or aseptic meningitis or external ventricular drain-associated ventriculitis. Bro. J. Neurosurg, 2000, 14, p.7-12.

Claims (2)

1. Dispozitiv de drenare a ventriculelor cerebrale, care conţine un tub elastic cu orificii de drenare şi cu capătul distal orb, pe partea proximală a tubului este îmbrăcat un manşon, iar capătul proximal al tubului este unit la un racord, în interiorul tubului este amplasat un tub elastic cu diametrul de 2…3 ori mai mic, capătul distal al căruia este unit la una din conexiunile racordului.1. Cerebral ventricle drainage device, which contains an elastic tube with drainage holes and a blind distal end, a sleeve is worn on the proximal side of the tube, and the proximal end of the tube is connected to a connector, inside the tube is placed an elastic tube with a diameter 2…3 times smaller, the distal end of which is connected to one of the connectors of the connector. 2. Metodă de drenare a ventriculelor cerebrale, care constă în aceea că se efectuează trepanarea cerebrală în regiunea frontală precoronară, se introduce dispozitivul definit în revendicarea 1 cu capătul orb în cavitatea ventriculului şi se efectuează evacuarea pasivă a lichidului cerebrospinal concomitent cu irigarea continuă prin introducerea în tubul cu diametrul mai mic a serului fiziologic, unui lichid similar lichidului cerebrospinal sau unui preparat antibacterian.2. Method for draining the cerebral ventricles, which consists in performing cerebral trepanation in the precoronary frontal region, inserting the device defined in claim 1 with the blind end into the ventricle cavity and performing passive evacuation of the cerebrospinal fluid simultaneously with continuous irrigation by introducing physiological saline, a liquid similar to cerebrospinal fluid or an antibacterial preparation into the tube with a smaller diameter.
MDS20090093A 2009-05-21 2009-05-21 Device and method for drainage of ventricle of brain MD128Z (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
MDS20090093A MD128Z (en) 2009-05-21 2009-05-21 Device and method for drainage of ventricle of brain

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
MDS20090093A MD128Z (en) 2009-05-21 2009-05-21 Device and method for drainage of ventricle of brain

Publications (2)

Publication Number Publication Date
MD128Y true MD128Y (en) 2010-01-29
MD128Z MD128Z (en) 2010-08-31

Family

ID=43568890

Family Applications (1)

Application Number Title Priority Date Filing Date
MDS20090093A MD128Z (en) 2009-05-21 2009-05-21 Device and method for drainage of ventricle of brain

Country Status (1)

Country Link
MD (1) MD128Z (en)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
MD795Z (en) * 2014-01-16 2015-02-28 Валерий ТИМИРГАЗ Controlled catheter
  • 2009

Also Published As

Publication number Publication date
MD128Z (en) 2010-08-31

Similar Documents

Publication Publication Date Title
RU62504U1 (en) MEDIUM DRAINING DEVICE
Rosenfeldt et al. Comparison between irrigation and conventional treatment for empyema and pneumonectomy space infection.
Rammos et al. Conversion of external ventricular drains to ventriculoperitoneal shunts after aneurysmal subarachnoid hemorrhage: effects of site and protein/red blood cell counts on shunt infection and malfunction
US8529546B2 (en) Sinusal guide cannula and kit for irrigation, suction and washing
CN209108385U (en) A kind of flushable drainage tube of multi-purpose type Y shape resistance to compression
CN103111010A (en) Double-cavity sacculus tube and application thereof
US20140364821A1 (en) System and method for draining fluids
CN102018724A (en) Preparation method of medical artificial cerebrospinal fluid and application thereof
MD128Y (en) Device and method for drainage of ventricle of brain
CN203736692U (en) Skull trepanation and drainage device for intracranial hematoma
CN106473817A (en) The pressure measurement that cooperation Flexible ureteroscope uses attracts clear stone device
CN215194889U (en) Three-cavity negative pressure wound irrigation drainage tube
CN106264642A (en) Single use temperature control liquid gel occlusion catheter and method for blocking
CN215194352U (en) Disposable through flushing drainage device
CN103877671B (en) Intracranial hematoma bores cranium drainage system
CN206526382U (en) The anti-blocking antibacterial isocon of anti-freezing
US20220379004A1 (en) Drug assisted wound drainage line
CN207654471U (en) A kind of vomica irrigation and drainage device
CN104042374A (en) Abdominal dropsy internal-drainage one-way support
RU2061411C1 (en) Method for treating acute hydrocephaly
RU2768463C1 (en) Method for acute pancreatitis treatment
CN207970290U (en) A kind of drainage device for neurosurgery operations
CN204411477U (en) A kind of three-cavity catheter with sealing joint
RU133737U1 (en) CATHETER FOR INTRAPROSTATIC DOSAGE OF MEDICINES
RU2355332C1 (en) Hydrocephaly surgery technique

Legal Events

Date Code Title Description
MK4Y Short term patent expired