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Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition) ›› 2019, Vol. 09 ›› Issue (01): 15-19. doi: 10.3877/cma.j.issn.2095-123X.2019.01.004

Special Issue:

• Clinical Research • Previous Articles     Next Articles

Influencing factors of shunt dependent hydrocephalus after continuous lumbar cistern drainage for aSAH

Chuanyu Li1, Haineng Huang2, Huadong Huang2, Huangde Fu2, Qisheng Luo2, Kunxiang Luo2, Chengjian Qin2, Xueyu Li2, Chuanhua Zheng2, Xiangyu Wang1,()   

  1. 1. Department of Neurosurgery, The First Affiliated Hospital of Ji’nan University, Guangzhou 510000, China
    2. Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
  • Received:2018-12-07 Online:2019-02-15 Published:2019-02-15
  • Contact: Xiangyu Wang
  • About author:
    Corresponding author: Wang Xiangyu, Email:

Abstract:

Objective

To explore the influential factors of hydrocephalus after continuous drainage of lumbar cistern in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods

One hundred and ten patients, from Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, with aSAH from January 2014 to July 2018 were chosen and divided into the observation group (n=27) and the control group (n=83) according to the occurrence of hydrocephalus. The therapeutic effects and clinical data of the two groups were compared.

Results

The rate of age >50 in the observation group was higher, and the Hunt-Hess classification and Fisher classification were higher than those of the control group, with more rupture of the posterior circulation aneurysm and more of the patients with cerebrospinal fluid flow than 150 mL (P<0.05). Age, intraventricular hemorrhage, Hunt-Hess score, Fisher score, daily drainage time of cerebrospinal fluid were significantly correlated with the occurrence of hydrocephalus after drainage in the observation group (P<0.05). The incidence of ventricular hemorrhage was significantly lower when the drainage time was longer than 1 week (P<0.05), but there was no significant correlation between the drainage time and Hunt-Hess and Fisher classification. The effective rate of treatment in the observation group was 62.96%, significantly lower than control group (86.75%). The incidence of complications in the observation group was 44.44%, which was significantly higher than that in the control group 10.84% (P<0.05).

Conclusion

Continuous lumbar cistern drainage is safe and feasible for the treatment of aSAH. Patients with older age (>50 years), higher Fisher and Hunt-Hess classification, intraventricular hemorrhage, cerebrospinal fluid drainage in short (1 week or less), cerebrospinal fluid flow less (<150 mL/d) are independent risk factors for the incidence of hydrocephalus after aSAH. To reduce these risk factors can reduce the occurrence of hydrocephalus and improve the prognosis of patients.

Key words: Hydrocephalus, Continuous lumbar cistern drainage, Aneurysmal subarachnoid hemorrhage, Ventricular hemorrhage

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