← All decks
The first 25 slides, exactly as they appear. The full deck has 49 content slides.
Neuro Critical Care
4 Lumbar Drain
Built from Jallo — Neurocritical Care Procedure Atlas
What’s inside
9 sections · 49 slides
Overview
- What this chapter teaches
Foundations
What a lumbar drain is, and the fluid it controls
- What is a lumbar drain?
- Cerebrospinal fluid by the numbers
- Where CSF comes from
- The one-way path CSF travels
- Anatomy of the lumbar cistern — why we drain low
Indications
When a lumbar drain earns its place
- The common thread across indications
- Indications at a glance
- Craniotomy — relaxing the brain
- Endoscopic skull base surgery
- CSF leak
- NPH — a diagnostic drainage trial
- Thoracoabdominal aortic surgery — protecting the cord
Contraindications
When placing a drain is dangerous
- Three broad reasons to say no
- Mass lesion and the herniation trap
- Infection and bleeding contraindications
Equipment
What is on the tray and why
- The lumbar drain tray
- Lumbar drain insertion kit
- The Tuohy needle — the workhorse
- Tuohy needle gauge and bevel
Technique
Step by step, with the safety rules built in
- The procedure at a glance
- Before you start — prep and positioning
- Left lateral decubitus positioning
- Setting up the kit
- Advancing the needle — reading the tissues
- Confirming CSF and threading the catheter
- Tuohy needle with catheter and guidewire inserted
- Removing the needle and securing the drain
Complications
What can go wrong, and the warning signs
- Complications overview
- Over-drainage — headache and herniation
- Infection
- Retained catheter
- Sheared, retained lumbar drain catheter
- Spinal cord injury and paresthesia
Expert suggestions
Troubleshooting a drain that misbehaves
- Over-drainage and catheter shearing
- No CSF return and a dry thecal sac
Summary
Bringing it together
- Key takeaways
- During catheter placement you meet resistance — what must you never do, and why?
- References
- Neuro ICU Procedure Atlas