Abstract
This study reflects on our experience in managing Sudanese children with different cranial conditions through external ventricular drain (EVD); indications for EVD, pathologies faced, and early outcome. A prospective review of cases operated at the National Center for Neurological Sciences was performed during the period from February 2014 to February 2016. The patients were closely followed till EVD removal and patient discharge. Thirty-five Sudanese children were included in the study (age range between 6 days to 7 years). The majority of the cases had posterior fossa tumor with obstructive hydrocephalus (n=19, 54.3%). Twenty patients (57.1%) presented with decreased level of consciousness while 28 (80%) patients presented with symptoms and signs of raised intracranial pressure (ICP). The decision for EVD was made preoperatively based on positive cranial computed tomography/magnetic resonance imaging (CT/MRI) findings in 10 patients (28.6%). Additionally, 28 patients (80%) responded to single injectable antibiotic therapy with an average duration of 22 days. Subsequently, 25 patients improved or got cured (71.4%), 5 deteriorated and 11 died. We concluded that EVD can be used for many indications including obstructive, post-infectious and post-meningitic hydrocephalus as well as intraventricular hemorrhage. Most patients may present with either deteriorating level of consciousness or symptoms and signs of raised ICP but few of them may have positive brain imaging findings and therefore the decision for EVD was made intra-operatively. The average duration for EVD use was 3 weeks with single antibiotic therapy use which was found as effective as when combined with intraventricular therapy.

Key words: External Ventricular drain, Children, indications, outcome