NeoCepha is a novel external ventricular drainage (EVD) platform designed to improve the management of hydrocephalus and other conditions requiring cerebrospinal fluid (CSF) diversion and intracranial pressure (ICP) control.

Acute neurocritical conditions like hydrocephalus and traumatic brain injury require urgent external ventricular drainage (EVD) and intracranial pressure (ICP) control, but current management relies on  passive systems with high rates of misplacement and clinical limitations. Conventional EVD relies on disjointed components—separate alignment guides, scalp suturing for fixation, gravity-fed drainage, and isolated pressure monitors—which risk catheter displacement, blockages, and limited therapeutic intervention. Innovators at Cincinnati Children’s Hospital Medical Center (in collaboration with Ben-Gurion University) created NeoCepha, a single, unified EVD platform that replaces these fragmented tools with an integrated system designed for guided placement, secure fixation, active fluid management, and real-time monitoring. NeoCepha combines three complementary technologies into a all-in-one platform: Optical Guidance System: Ensures precise ventricular targeting and placement. Sutureless Fixation Device: Anchors the catheter firmly at the intended trajectory and depth without traditional scalp sutures. Active Ventricular Pump: Enables controlled cerebrospinal fluid (CSF) drainage, dynamic ventricular lavage, direct intraventricular medication delivery, and continuous ICP monitoring.

NeoCepha is intended for use in patients requiring temporary ventricular drainage and ICP management, including those with hydrocephalus, traumatic brain injury (TBI), intracranial hemorrhage, brain tumors, infections and post-neurosurgical complications.

Unlike conventional gravity-based EVD systems, NeoCepha integrates ventricular access, fixation, ICP monitoring, and active fluid management into a unified platform. The guided placement system is designed to reduce reliance on anatomical landmarks and freehand catheter insertion techniques, while the fixation mechanism helps maintain catheter position without traditional scalp suturing. The active pump concept enables continuous ICP monitoring, automated fluid management, ventricular irrigation, medication administration, and potential catheter flushing capabilities, creating opportunities for more advanced neurocritical care management than currently available passive drainage systems

External ventricular drainage (EVD) is one of the most common neurosurgical procedures for pediatric and adult patients requiring acute decompression and pressure control due to hydrocephalus, traumatic brain injury (TBI), intracranial hemorrhage, post-surgical care and infections. TAM (Worldwide): Estimated at $240,000,000/year (calculated at ~$4,000 per procedure across 60,000–600,000 annual global EVD placements). (Note: TAM is estimated at $1.5B/year). SAM (US Market): Estimated at $100,000,000/year based on ~25,000 EVD procedures per year in the US. The advanced feature portion (active pumping/monitoring) represents $300M–$600M/year of the broader market. SOM (5-Year Projection): Estimated conservatively at 1% SAM or $1,000,000/year with potential for up to 5% market penetration $4,000,000–$6,000,000/year depending on commercial adoption and execution.

Francesco Mangano, DO, FACS, David Zarrouk, PhD, MSc, Atai Daniel, PhD, MSc