Case study 9
Operative note
Preoperative diagnosis: Increased intracranial pressure and cerebral edema due to severe brain injury.
Postoperative diagnosis: Increased intracranial pressure and cerebral edema due to severe brain injury.
Procedure: Scalp was clipped. Patient was prepped with Chlorprep and Betadine. Incisions were infiltrated with 1% xylocaine with epinephrine 1:200000. Patient did receive antibiotics post procedure and was draped in a sterile manner. The incision was made just to the right of the mid-pupillary line, 10 cm behind the nasion. A self retaining retractor was placed. A hole was drilled with the cranial twist drill and the dura was punctured.
A brain needle was used to localize the ventricle and it took 3 passes to localize the ventricle. The pressure was initially high. The CSF was clear and colorless. The CSF drainage rapidly tapered off because of brain swelling. With two tries, the ventricular Cather was placed into the ventricle and then brought out through a separate puncture site. The depth of the catheter was 7 cm from the outer table of skull. There was intermittent drainage of CSF after that. The catheter was secured to the scalp with a #2-0 silk sutures and the incision was closed with ethilon suture. The patient tolerated the procedure well, with no complications. Sponge and needle counts were correct. Blood loss was minimal.

A.61107,62160
B. 61210
C. 61107
D. 61210, 62160