Ventricular catheter misplacement
🧠 Ventricular Catheter: Misplacement vs Malposition
This section outlines the key differences between misplacement and malposition of ventricular catheters, which are important for interpreting postoperative imaging and assessing functionality.
📌 Definition Table
| Term | Definition | Key Features | Example |
|---|---|---|---|
| Misplacement | Catheter is completely outside the intended anatomical target (ventricle). | * Ventricles not accessed.<br> * Non-functional.<br> * Risk of hemorrhage or brain injury. | Tip located in brain parenchyma or subarachnoid space. |
| Malposition | Catheter is inside the ventricle, but in a suboptimal position. | * Still within ventricle.<br> * May be functional.<br> * Increased risk of occlusion or failure. | Tip near choroid plexus or wall of posterior horn. |
✅ Summary
- Misplacement = The catheter missed the ventricle.
- Malposition = The catheter entered the ventricle, but the tip is not ideally placed (e.g., far from CSF flow or near choroid).
- Both conditions may compromise catheter function and should be reported in post-op imaging.*
Ventricular catheter placement is one of the fundamental procedures of emergency neurosurgery usually performed freehand at the bedside or in the operating room using anatomical landmarks. However, this technique is frequently associated with malpositioning leading to complications or dysfunction.
Misplacement in eloquent brain tissue can result in serious morbidities such as coma, pial arteriovenous fistula, upgaze palsy, and iatrogenic pseudoaneurysm.