Intraventricular haematoma: management of comatose patients with valve regulated external ventricular drainage.

Over a 2-year period, 22 consecutive comatose patients (Glasgow Coma Score of less than or equal to 8) with intraventricular haematomas were managed with prolonged external ventricular drainage via an external one-way valve regulated system. The mean duration of drainage was 12 days. The overall mortality was 23%. According to the Glasgow Outcome Scale, 36% had severe to moderate disability and 41% made good recovery. Mortality and morbidity were closely related to the type of intraventricular haematoma and patients' preoperative clinical state. Drainage related complications: infection, and ventricular catheter blockage requiring revision, were not observed as a result of this technique. Of the survivors, nine eventually required ventriculoperitoneal shunts. Sump and valve regulated external ventricular drainage is, therefore, a useful procedure in the management of patients with extensive intraventricular haematoma.