Insertion of an EVD catheter is one of the common lifesaving procedures at the neurological intensive care unit. It can be beneficial in cases of hemorrhage, traumatic brain injury, and bacterial meningitis. A freehand pass technique using surface landmarks is commonly used. However, due to anatomical variations, this technique results in complications. Neurosurgical Navigation systems are used to improve performance. State-of-the-Art systems have positional accuracy below 2 mm and 2 degrees. However, those are relatively expensive and can be maintained only by major hospitals and, due to the large size of the system, those cannot be used at the bedside or in the field.

This report is a proposal for a neurosurgical navigation system designed for EVD catheter insertion procedures. It would have accuracy approaching State-of-the-Art systems, would be affordable for local hospitals, hospitals in developing countries and would be capable of bedside and in field use. The system consists of a 4-joint arm with rotary encoders and microcontroller for mechanical localization and a software on PC for position interpretation and overlaying tool position on a 2D/3D preoperative scan. The system, being mounted at the incision hole, will allow the patient head movement without re-registration.

As of April 2020, the system approaches target accuracy with worst case accuracy of 3.5 mm in the registration area and 2.17 mm, 1.51 deg accuracy in the ventricles area, before registration. The device position and trajectory are overlaid on a medical image (CT or MRI) in 3D space in real-time.

Michael Borovik would like to thank their faculty sponsor Dr. Gary Bledsoe for their support of this project.