The Nelaton Catheter Guard for Safe and Effective Placement of Subdural Drain for Two-Burr-Hole Trephination in Chronic Subdural Hematoma: A Technical Note

BACKGROUND For chronic subdural hematoma, placement of a Blake drain with a two-burr-hole craniotomy is often preferred. However, the placement of such drains carries the risk of penetrating the brain surface or damaging superficial venous structures. OBJECTIVE To describe the use of a Nelaton catheter for the placement of a subdural drain in two-burr-hole trephination for chronic subdural hematoma. METHOD A Nelaton catheter was used to guide placement of a Blake drain into the subdural hematoma cavity and provide irrigation of the hematoma cavity. With the two-burr-hole method, the Nelaton catheter could be removed easily via the frontal burr hole after the Blake drain was in place. RESULTS We used the Nelaton catheters in many surgical procedures and found it a safe and easy technique. This method allows the surgeon to safely direct the catheter into the correct position in the subdural space. CONCLUSIONS This tool has two advantages. First, the use of a small and flexible Nelaton catheter is a safe method for irrigation of a chronic subdural hematoma cavity. Second, in comparison with insertion of subdural drainage alone through a burr hole, the placement of the Nelaton catheter in subdural space is easier and the risk of damaging relevant structures such as cortical tissue or bridging veins is lower. Thus this technique may help to avoid complications when placing a subdural drain.

[Future cardiac pacemakers – technical visions].

Cardiac pacemakers are routinely used for the treatment of bradyarrhythmias. Contemporary pacemakers are reliable and allow for a patient specific programming. However, pacemaker replacements due to battery depletion are common (~25 % of all implantation procedures) and bear the risk of complications. Batteryless pacemakers may allow overcoming this limitation. To power a batteryless pacemaker, a mechanism for intracorporeal energy harvesting is required. Such a generator may consist out of subcutaneously implanted solar cells, transforming the small amount of transcutaneously available light into electrical energy. Alternatively, intravascular turbines may harvest energy from the blood flow. Energy may also be harvested from the ventricular wall motion by a dedicated mechanical clockwork converting motion into electrical energy. All these approaches have successfully been tested in vivo. Pacemaker leads constitute another Achilles heel of contemporary pacemakers. Thus, leadless devices are desired. Miniaturized pacemaker circuits and suitable energy harvesting mechanisms (incorporated in a single device) may allow catheter-based implantation of the pacemaker in the heart. Such miniaturized battery- and leadless pacemakers would combine the advantages of both approaches and overcome major limitations of today’s systems.

IGS Technical Report 2011

Applications of the Global Navigation Satellite Systems (GNSS) to Earth Sciences are numerous. The International GNSS Service (IGS), a federation of government agencies, universities and research institutions, plays an increasingly critical role in support of GNSS–related research and engineering activities. This Technical Report 2011 includes contributions from the IGS Governing Board, the Central Bureau, Analysis Centers, Data Centers, station and network operators, and others highlighting status and important activities, changes and results that took place and were achieved during 2011.

IGS Technical Report 2012

Applications of the Global Navigation Satellite Systems (GNSS) to Earth Sciences are numerous. The International GNSS Service (IGS), a federation of government agencies, universities and research institutions, plays an increasingly critical role in support of GNSS–related research and engineering activities. This Technical Report 2012 includes contributions from the IGS Governing Board, the Central Bureau, Analysis Centers, Data Centers, station and network operators, and others highlighting status and important activities, changes and results that took place and were achieved during 2012.

IGS Technical Report 2013

Applications of the Global Navigation Satellite Systems (GNSS) to Earth Sciences are numerous. The International GNSS Service (IGS), a federation of government agencies, universities and research institutions, plays an increasingly critical role in support of GNSS–related research and engineering activities. This Technical Report 2013 includes contributions from the IGS Governing Board, the Central Bureau, Analysis Centers, Data Centers, station and network operators, and others highlighting status and important activities, changes and results that took place and were achieved during 2013.

IGS Technical Report 2014

Applications of the Global Navigation Satellite Systems (GNSS) to Earth Sciences are numerous. The International GNSS Service (IGS), a federation of government agencies, universities and research institutions, plays an increasingly critical role in support of GNSS–related research and engineering activities. This Technical Report 2014 includes contributions from the IGS Governing Board, the Central Bureau, Analysis Centers, Data Centers, station and network operators, and others highlighting status and important activities, changes and results that took place and were achieved during 2014.

IGS Technical Report 2015

Applications of the Global Navigation Satellite Systems (GNSS) to Earth Sciences are numerous. The International GNSS Service (IGS), a federation of government agencies, universities and research institutions, plays an increasingly critical role in support of GNSS–related research and engineering activities. This Technical Report 2015 includes contributions from the IGS Governing Board, the Central Bureau, Analysis Centers, Data Centers, station and network operators, and others highlighting status and important activities, changes and results that took place and were achieved during 2015.