The Role of Lumbar Drainage to Prevent Shunt-Dependent Hydrocephalus after Coil Embolization for Aneurysmal Subarachnoid Hemorrhage in Good-Grade Patients.
10.3340/jkns.2010.48.6.480
- Author:
Cho In YONG
1
;
Sung Kyun HWANG
;
Sung Hak KIM
Author Information
1. Department of Neurosurgery, College of Medicine, Ewha Womans University, Seoul, Korea. nsksh@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Coil embolization;
Hydrocephalus;
Lumbar drainage;
Shunt
- MeSH:
Aneurysm;
Craniocerebral Trauma;
Drainage;
Follow-Up Studies;
Headache;
Humans;
Hydrocephalus;
Intracranial Aneurysm;
Retrospective Studies;
Subarachnoid Hemorrhage;
Surgical Instruments
- From:Journal of Korean Neurosurgical Society
2010;48(6):480-484
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the role of lumbar drainage in the prevention of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by coil embolization in good-grade patients. METHODS: One-hundred-thirty consecutive patients with aneurysmal subarachnoid hemorrhage in good-grade patients (Hunt & Hess grades I-III), who were treated by coil embolization between August 2004 and April 2010 were retrospectively evaluated. Poor-grade patients (Hunt & Hess grades IV and V), a history of head trauma preceding the development of headache, negative angiograms, primary subarachnoid hemorrhage (SAH), and loss to follow-up were excluded from the study. We assessed the effects on lumbar drainage on the risk of shunt-dependent hydrocephalus related to coil embolization in patients with ruptured intracranial aneurysms. RESULTS: One-hundred-twenty-six patients (96.9%) did not develop shunt-dependent hydrocephalus. The 2 patients (1.5%) who developed acute hydrocephalus treated with temporary external ventricular drainage did not require permanent shunt diversion. Overall, 4 patients (3.1%) required permanent shunt diversion; acute hydrocephalus developed in 2 patients (50%). There was no morbidity or mortality amongst the patients who underwent a permanent shunt procedure. CONCLUSION: Coil embolization of ruptured intracranial aneurysms may be associated with a lower risk for developing shunt-dependent hydrocephalus, possibly by active management of lumbar drainage, which may reflect less damage for cisternal anatomy than surgical clipping. Coil embolization might have an effect the long-term outcome and decision-making for ruptured intracranial aneurysms.
