Catheter Occlusion in External Ventricular Drainage: The “VISTA” Mnemonic

Introduction External ventricular drains (EVDs) are common in neurocritical care for monitoring and treating intracranial pressure (ICP).[ 1 ] Despite their usefulness, occlusion is a well-known and potentially life-threatening complication. Causes of obstruction include intracranial hypotension, coagulated blood, tissue debris, and collapse of the ventricular wall around the catheter ([ Table 1 ]). Early detection and timely intervention are paramount to keeping the catheter useful and avoiding secondary brain injury. Table 1 Causes of cessation of CSF flow in the EVD Mechanical Kink/disconnection Catheter malposition Filter occlusion Hypotension with collapsed ventricles Cellular debris Blood Tissue fragments Ventriculitis Diversion CSF leak away from the site of EVD Over-drainage Decompression on the contralateral side Abbreviations: CSF, cerebrospinal fluid; EVD, external ventricular drain. Publication History Article published online: 21 April 2025 © 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd.