External ventricular drainage in modern neurosurgical practice: optimization, standardization, and emerging guidance technologies

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External ventricular drain (EVD) placement is essential for cerebrospinal fluid diversion and intracranial pressure monitoring in neurosurgery.
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Conventional freehand EVD techniques show significant variability in accuracy and increased complication risks due to anatomical challenges.
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Adjunct guidance technologies like ultrasound, electromagnetic navigation, and augmented reality improve EVD placement accuracy and reduce complications.
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Electromagnetic navigation consistently performs well across settings, while augmented reality offers potential advantages in portability and integration.
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Standardization and validation of guided techniques are crucial for enhancing patient safety and reducing variability in ventriculostomy practices.

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