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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

Title
The role of lumbar drainage to prevent shunt-dependent Hydrocephalus after coil embolization for aneurysmal subarachnoid Hemorrhage in good-grade patients
Authors
Yong C.I.Hwang S.-K.Kim S.-H.
Ewha Authors
김성학황승균
SCOPUS Author ID
김성학scopus; 황승균scopus
Issue Date
2010
Journal Title
Journal of Korean Neurosurgical Society
ISSN
2005-3711JCR Link
Citation
vol. 48, no. 6, pp. 480 - 484
Indexed
SCIE; SCOPUS WOS scopus
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. © 2010 The Korean Neurosurgical Society.
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의과대학 > 의학과 > Journal papers
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