From the Research
The Keen point for ventricular catheter insertion is located 5.5 cm behind and 6 cm above the tragus, with a trajectory directed toward the ipsilateral medial canthus of the eye, as supported by the most recent study 1. The location and trajectory for ventricular catheter insertion through the Keen point are critical for successful ventriculostomy.
- The Keen point is an alternative entry point to the more commonly used Kocher's point, and its location is essential for avoiding complications and ensuring proper catheter placement.
- The study by 1 provides the most recent and accurate information on the location of the Keen point, which is 5.5 cm behind and 6 cm above the tragus.
- The trajectory for catheter insertion should be directed toward the ipsilateral medial canthus of the eye, which helps to avoid eloquent brain tissue and major vascular structures.
- After making a small burr hole at the Keen point, the catheter should be advanced approximately 4-6 cm deep, depending on the patient's anatomy, to access the atrium of the lateral ventricle through the posterior parietal region.
- It is essential to confirm proper placement with imaging after insertion and be mindful of anatomical variations that may require slight adjustments to the trajectory, as noted in the study by 2.
- The Keen point is particularly useful when the frontal approach is contraindicated or technically challenging, such as in cases of frontal trauma or infection, and provides reliable access to the ventricular system for CSF drainage, pressure monitoring, or medication administration.
- A recent study 3 also highlights the importance of precise anatomical localization for ventriculostomy, although it focuses on a modified Kocher's point, emphasizing the need for careful consideration of entry points and trajectories in neurosurgical procedures.