Kocher's Point
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Kocher's Point
Kocher's point is a common entry point through the frontal bone for an intraventricular catheter to drain cerebrospinal fluid from the anterior horn of the lateral ventricles, lateral ventricle. It is located 2–3 centimeters lateral to the midline (at approximately the mid-pupillary line) and approximately 11 cm posterior to the nasion, or 10 cm posterior from the glabella. During cannulation of the Lateral ventricles, lateral ventricle, Kocher's point is landmarked as a point of entry, and care must be taken to be at least 1 cm anterior to the coronal suture to avoid damaging the primary motor cortex. It is most often used to remove cerebrospinal fluid for the treatment of hydrocephalus. See also * Ventriculostomy References

Human head and neck Neurosurgery {{Surgery-stub ...
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Frontal Bone
The frontal bone is a bone in the human skull. The bone consists of two portions.''Gray's Anatomy'' (1918) These are the vertically oriented squamous part, and the horizontally oriented orbital part, making up the bony part of the forehead, part of the bony orbital cavity holding the eye, and part of the bony part of the nose respectively. The name comes from the Latin word ''frons'' (meaning " forehead"). Structure of the frontal bone The frontal bone is made up of two main parts. These are the squamous part, and the orbital part. The squamous part marks the vertical, flat, and also the biggest part, and the main region of the forehead. The orbital part is the horizontal and second biggest region of the frontal bone. It enters into the formation of the roofs of the orbital and nasal cavities. Sometimes a third part is included as the nasal part of the frontal bone, and sometimes this is included with the squamous part. The nasal part is between the brow ridges, and ends in ...
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Catheter
In medicine, a catheter (/ˈkæθətər/) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Catheters are manufactured for specific applications, such as cardiovascular, urological, gastrointestinal, neurovascular and ophthalmic procedures. The process of inserting a catheter is ''catheterization''. In most uses, a catheter is a thin, flexible tube (''soft'' catheter) though catheters are available in varying levels of stiffness depending on the application. A catheter left inside the body, either temporarily or permanently, may be referred to as an "indwelling catheter" (for example, a peripherally inserted central catheter). A permanently inserted catheter may be referred to as a "permcath" (originally a trademark). Catheters can be inserted into a body cavity, duct, or vessel, brain, skin or adipose tissue. Functionally, they all ...
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Cerebrospinal Fluid
Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates. CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the brain, and absorbed in the arachnoid granulations. There is about 125 mL of CSF at any one time, and about 500 mL is generated every day. CSF acts as a shock absorber, cushion or buffer, providing basic mechanical and immunological protection to the brain inside the skull. CSF also serves a vital function in the cerebral autoregulation of cerebral blood flow. CSF occupies the subarachnoid space (between the arachnoid mater and the pia mater) and the ventricular system around and inside the brain and spinal cord. It fills the ventricles of the brain, cisterns, and sulci, as well as the central canal of the spinal cord. There is also a connection from the subarachnoid space to the bony labyrinth of the inner ear via the perilymphat ...
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Lateral Ventricles
The lateral ventricles are the two largest ventricles of the brain and contain cerebrospinal fluid (CSF). Each cerebral hemisphere contains a lateral ventricle, known as the left or right ventricle, respectively. Each lateral ventricle resembles a C-shaped cavity that begins at an inferior horn in the temporal lobe, travels through a body in the parietal lobe and frontal lobe, and ultimately terminates at the interventricular foramina where each lateral ventricle connects to the single, central third ventricle. Along the path, a posterior horn extends backward into the occipital lobe, and an anterior horn extends farther into the frontal lobe. Structure Each lateral ventricle takes the form of an elongated curve, with an additional anterior-facing continuation emerging inferiorly from a point near the posterior end of the curve; the junction is known as the ''trigone of the lateral ventricle''. The centre of the superior curve is referred to as the ''body'', while the three ...
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Nasion
The nasion () is the most anterior point of the frontonasal suture that joins the nasal part of the frontal bone and the nasal bones. It marks the midpoint at the intersection of the frontonasal suture with the internasal suture joining the nasal bones. It is visible on the face as a distinctly depressed area directly between the eyes, just superior to the bridge of the nose. It is a cephalometric landmark that is just below the glabella The glabella, in humans, is the area of skin between the eyebrows and above the nose. The term also refers to the underlying bone that is slightly depressed, and joins the two brow ridges. It is a cephalometric landmark that is just superior to .... References {{Authority control Facial features ...
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Glabella
The glabella, in humans, is the area of skin between the eyebrows and above the nose. The term also refers to the underlying bone that is slightly depressed, and joins the two brow ridges. It is a cephalometric landmark that is just superior to the nasion. Etymology The term for the area is derived from the Latin , meaning 'smooth, hairless'. In medical science The skin of the glabella may be used to measure skin turgor in suspected cases of dehydration by gently pinching and lifting it. When released, the glabella of a dehydrated patient tends to remain extended ("tented"), rather than returning to its normal shape. See also * Glabellar reflex The glabellar reflex, also known as the "glabellar tap sign", is a primitive reflex elicited by repetitive tapping of the the smooth part of the forehead above the nose and between the eyebrows. Subjects respond to the first several taps by blink ... References Bones of the head and neck {{musculoskeletal-stub ...
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Lateral Ventricles
The lateral ventricles are the two largest ventricles of the brain and contain cerebrospinal fluid (CSF). Each cerebral hemisphere contains a lateral ventricle, known as the left or right ventricle, respectively. Each lateral ventricle resembles a C-shaped cavity that begins at an inferior horn in the temporal lobe, travels through a body in the parietal lobe and frontal lobe, and ultimately terminates at the interventricular foramina where each lateral ventricle connects to the single, central third ventricle. Along the path, a posterior horn extends backward into the occipital lobe, and an anterior horn extends farther into the frontal lobe. Structure Each lateral ventricle takes the form of an elongated curve, with an additional anterior-facing continuation emerging inferiorly from a point near the posterior end of the curve; the junction is known as the ''trigone of the lateral ventricle''. The centre of the superior curve is referred to as the ''body'', while the three ...
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Primary Motor Cortex
The primary motor cortex (Brodmann area 4) is a brain region that in humans is located in the dorsal portion of the frontal lobe. It is the primary region of the motor system and works in association with other motor areas including premotor cortex, the supplementary motor area, posterior parietal cortex, and several subcortical brain regions, to plan and execute voluntary movements. Primary motor cortex is defined anatomically as the region of cortex that contains large neurons known as Betz cells, which, along with other cortical neurons, send long axons down the spinal cord to synapse onto the interneuron circuitry of the spinal cord and also directly onto the alpha motor neurons in the spinal cord which connect to the muscles. At the primary motor cortex, motor representation is orderly arranged (in an inverted fashion) from the toe (at the top of the cerebral hemisphere) to mouth (at the bottom) along a fold in the cortex called the central sulcus. However, some body parts ...
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Hydrocephalus
Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs within the brain. This typically causes increased intracranial pressure, pressure inside the skull. Older people may have headaches, double vision, poor balance, urinary incontinence, personality changes, or mental impairment. In babies, it may be seen as a rapid increase in head size. Other symptoms may include vomiting, sleepiness, seizures, and Parinaud's syndrome, downward pointing of the eyes. Hydrocephalus can occur due to birth defects or be acquired later in life. Associated birth defects include neural tube defects and those that result in aqueductal stenosis. Other causes include meningitis, brain tumors, traumatic brain injury, intraventricular hemorrhage, and subarachnoid hemorrhage. The four types of hydrocephalus are communicating, noncommunicating, ''ex vacuo'', and normal pressure hydrocephalus, normal pressure. Diagnosis is typically made by physical examination and medic ...
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Ventriculostomy
Ventriculostomy is a neurosurgical procedure that involves creating a hole (stoma) within a cerebral ventricle for drainage. It is most commonly performed on those with hydrocephalus. It is done by surgically penetrating the skull, dura mater, and brain such that the ventricular system ventricle of the brain is accessed. When catheter drainage is temporary, it is commonly referred to as an external ventricular drain (EVD). When catheter drainage is permanent, it is usually referred to as a shunt. There are many catheter-based ventricular shunts that are named for where they terminate, for example, a ventriculi-peritoneal shunt terminates in the peritoneal cavity, a ventriculoarterial shunt terminates within the atrium of the heart, etc. The most common entry point on the skull is called Kocher's point, which is measured 11 cm posterior to the nasion and 3 cm lateral to midline. EVD ventriculostomy is done primarily to monitor the intracranial pressure as well as to drain ...
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Human Head And Neck
Humans (''Homo sapiens'') are the most abundant and widespread species of primate, characterized by bipedalism and exceptional cognitive skills due to a large and complex brain. This has enabled the development of advanced tools, culture, and language. Humans are highly social and tend to live in complex social structures composed of many cooperating and competing groups, from families and kinship networks to political states. Social interactions between humans have established a wide variety of values, social norms, and rituals, which bolster human society. Its intelligence and its desire to understand and influence the environment and to explain and manipulate phenomena have motivated humanity's development of science, philosophy, mythology, religion, and other fields of study. Although some scientists equate the term ''humans'' with all members of the genus ''Homo'', in common usage, it generally refers to ''Homo sapiens'', the only extant member. Anatomically mode ...
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