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, Andrés F. Salazar

Santiago Cardona-Collazos, Denis Hermosa, Shugar Hinojosa, Amaya Alvarez, Eve Tsai, Adrián Zapata

Mario Canitrot, Robson Amorim, Piedad Acurio, Luigi Berra, Ahmed El Fiki, Leonardo Zapata, Marcos Wagner

Mario Ganau, Wellingson Paiva, Andrew Reisner, Oscar Alves

Brain and Spine, Volume 6, Article 106142

2026

Abstract

Intracranial hypertension is a life-threatening complication of traumatic brain injury (TBI) and a major target in neurocritical care. While ventriculostomy for cerebrospinal fluid diversion and the emerging technique of cisternostomy are used on a regular basis in different areas of the world, their application is heterogeneous on indications, timing and technical aspects in surgical procedures. This variability highlights a critical lack of standardized protocols, particularly in resource-constrained environments where optimized recommendations are most needed.