Clinical value of percutaneous needle trephination (PNT)

Summary In 56 neurosurgical patients 70 percutaneous needle trephinations were performed. This method was mostly used in patients with acute increase of ICP due to occlusive hydrocephalus of various aetiologies. Thanks to the accuracy and exhaustiveness of CT information, and thanks to the simplicity and safety of percutaneous needle trephination, this latter could be more and more used in daily clinical practice as a diagnostic and therapeutic procedure, for example for the study of adult hydrocephalus, for provisional external ventricular drainage, for treatment of CSF infections, and for ventricular bleedings (also in newborns and premature infants). No serious complication was seen even after prolonged CSF drainage over a period of 41 days. The method of PNT, as described in detail, can be used under sterile conditions at the bedside, on the stretcher in the emergency room, or in the CT or X-ray laboratory. It fulfils the criteria for clinical acceptance: simplicity, low risk, reliability, exactness, and effectiveness.