Extraventricular Drainage and Hematoma Evacuation to Treat Hydrocephalus Following Lysis of MCA Embolism

1. Introduction

1. Preparation and Draping

2. Extraventricular Drain

1. Skin Marking and Incision
2. Drill through Corticalis
3. Identify and Open Dura
4. Insert Extraventricular Drain
5. Fix Drain to Scalp
6. Close Wound

3. Right-Sided Sub-Occipital Craniotomy

1. Mark Midline and Inion
2. Identify Inion
3. Make Midline Incision
4. Remove Overlaying Musculature
5. Drill Burr Holes
6. Use Craniotome and Remove Bone Flap
7. Insert Dura Suture
   

4. Relieve Hematoma Under Microscope

1. Enter Cerebellum
2. Suction Hematoma and Control Bleeding
3. Insert Wire Mesh and Spray Dural Sealant
4. Place Artificial Bone Putty

5. Craniotomy Closure

1. Attach Bioplates to Artificial Bone
2. Fasten Artificial Bone to Skull
3. Close Wound

6. Post-op Remarks