Recommendations for ventriculostomy and cisternostomy in TBI management: Results of the…

StudyBrain & spine· 2026

Recommendations for ventriculostomy and cisternostomy in TBI management: Results of the WFNS-Neurotraumatology committee "Cusco consensus".

Andrés M Rubiano, Wendy D Gonzalez-Tobar, Laura M Loaiza-Cardona … Oscar Alves

NeurotraumaStudyQ3IF 2.0

International expert panel agreed on 69 statements standardizing ventriculostomy and cisternostomy use in traumatic brain injury.

Recommendations for ventriculostomy and cisternostomy in TBI management: Results of the WFNS-Neurotraumatology committee "Cusco consensus".

Andrés M Rubiano … Oscar Alves

Brain & spine · 2026

Background

Intracranial hypertension is a life-threatening complication of traumatic brain injury (traumatic brain injury) and a major target in neurocritical care.

Purpose

The statements aim to harmonize global practice and direct future research.

Methods

The Neurotrauma Committee of the World Federation of Neurosurgical Societies develop an international consensus, including a methodological group and a panel of 16 expert neurosurgeons following a Delphi process, involving systematic literature review, statement formulation, and iterative blinded voting using a 5-point Likert scale.

69

Results

69

Number of consensus recommendations approved by expert neurosurgeon panel via Delphi voting.

More results

Core recommendations advocate for ventriculostomy as an early therapeutic intervention for traumatic brain injury requiring fluid drainage and define cisternostomy as an adjunctive procedure for selected patients with traumatic brain injury and significant traumatic subarachnoid hemorrhage.

Protocols with algorithms were proposed for both procedures.

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Conclusion · 1 of 2

This consensus provides a practical framework to guide surgical management of traumatic brain injury using ventriculostomy and or cisternostomy as techniques.

Conclusion · 2 of 2

It promotes a strategic shift towards prior heterogeneous concepts on ventriculostomy and defines a specific, consensus-guided role for cisternostomy. The statements aim to harmonize global practice and direct future research.

Recommendations for ventriculostomy and cisternostomy in TBI management: Results of the WFNS-Neurotraumatology committee "Cusco consensus".

Recommendations for ventriculostomy and cisternostomy in TBI management: Results of the WFNS-Neurotraumatology committee "Cusco consensus".

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