Ventriculostomy-Related Infections

To the Editor: The observations of Mayhall et al. (March 1 issue),* indicating that the risk of iatrogenic Central-nervous-system infection rises with the duration of intracranial-pressure monitoring, are incomplete and may be misleading. With the cumulative incidence of a prior infectious complication reaching 9 per cent by Day 5 and 21, 37, and 42 per cent by Days 8, 10, and 11, respectively, the authors recommend removal of the ventriculostomy catheter by Day 5. When more prolonged monitoring of intracranial pressure is indicated, they advocate insertion of a new catheter. Unfortunately, evaluation of the cumulative risk of a prior infection.