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The role of lumbar drainage to prevent shunt-dependent hydrocephalus after coil embolization for aneurysmal subarachnoid hemorrhage in good-grade patients.
MedLine Citation:
PMID:  21430972     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Cho In Yong; Sung-Kyun Hwang; Sung-Hak Kim
Publication Detail:
Type:  Journal Article     Date:  2010-12-31
Journal Detail:
Title:  Journal of Korean Neurosurgical Society     Volume:  48     ISSN:  1598-7876     ISO Abbreviation:  J Korean Neurosurg Soc     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-03-24     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101467054     Medline TA:  J Korean Neurosurg Soc     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  480-4     Citation Subset:  -    
Affiliation:
Department of Neurosurgery, College of Medicine, Ewha Womans University, Seoul, Korea.
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