What is Intraventricular Access Device Placement

Intraventricular access device placement is a surgery to put an intraventricular access device under the scalp. This device is used to deliver medicines to the fluid that surrounds the brain and spinal cord (cerebrospinal fluid).

An intraventricular device is made up of two parts:

• A small piece called a reservoir.
• Flexible tubing called a catheter.

The device can usually stay in the scalp permanently.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur. These include:

• Issues with the healing of the area where the surgical cut (incision) was made.
• Infection in the area around the device.
• The catheter moving out of place.
• Needing another surgery to remove or replace the device.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures.

What happens before the procedure?

• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
  • Stopping vitamin E. You may need to stop taking this vitamin two weeks before your procedure.
• Ask your health care provider if you will need to stay at the hospital overnight after the procedure. If you are told that you will not need to stay overnight, plan to have someone take you home.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins. It will be used to give you medicine.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
• A cut (incision) will be made in your scalp.
• A small hole will be drilled in your skull.
• The reservoir will be placed in the hole.
• Tubing will be threaded into a hollow area in your brain.
• The skin that covers the device will be closed with stitches (sutures) or staples.
• Your sutures or staples may be covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• If you need to stay at the hospital overnight, you will be moved to a hospital room.
• The intraventricular access device may be tested. If this is done, you will need to lie flat for about 30 minutes or until your health care provider says it is okay to sit up. Your health care provider will clean an area of your scalp, then he or she will insert medicine into the device through a needle.
• Do not drive for 24 hours if you received a sedative.

Intraventricular Access Device Placement, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After your procedure, you will have a small bump on your head where the device is located.

Follow these instructions at home:

Incision care

• Do not wash your hair or your scalp until the area is healed.
• Follow instructions from your health care provider about how to take care of your surgical cut (incision). Make sure you:
  • Do not let the incision area get wet. Keep this area dry until the stitches or staples have been removed.
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures) or staples in place. These skin closures may need to stay in place for 2 weeks or longer.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Driving

• Do not drive for 24 hours after you receive a sedative.
• Do not drive or operate heavy machinery while taking prescription pain medicine.

General instructions

• Take extra care to avoid bumping or injuring the area where the device is located.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain at the site of your incision.
• You have fluid or blood coming from your incision.
• Your incision area feels warm to the touch.
• You have pus or a bad smell coming from your incision or dressing.
• You develop a pounding or throbbing headache.
• You begin vomiting.

Get help right away if:

• You feel unusually drowsy, dull, and sluggish (lethargic).
• You feel disoriented.
• Your vision becomes blurry.
• You start to see double.
• You vomit forcefully.
• You develop a fever.
• Your neck or your back feels unusually stiff.