Is Good Good Enough?

Excerpt

Ventriculostomy for cerebrospinal fluid diversion, either externalized as a temporary drain or internalized as a permanent shunt, is a frequently performed, clinically invaluable procedure. In this issue, two studies concerning the accuracy and morbidity of this procedure are reported: one a large, single institution’s 5-year experience with external ventricular drains and ventricular shunts placed by their neurosurgical service, and the other, a smaller, 3-year experience with external ventricular drain and intracranial pressure monitor placement by a single, specially trained neurointensivist. The former documents a well-established service’s track record, contributing to the literature’s collective benchmarking experience; the latter also documents an institution’s track record, but in this instance, as part of an effort to validate the practice of non-neurosurgical neurointensivists engaging in this activity. …