Publication:
Lumbar drainage and low rate of permanent shunt insertion after treating aneurysmal subarachnoid hemorrhage

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Issued Date

2016

Resource Type

Article

File Type

application/pdf

ISSN

1252208

Other identifier(s)

2-s2.0-84983416806

Rights Holder(s)

Scopus

Bibliographic Citation

Journal of the Medical Association of Thailand. Vol 99, (2016), p.S47-S53

Suggested Citation

Boonyawanakij T., Tirakotai W., Liengudom A. Lumbar drainage and low rate of permanent shunt insertion after treating aneurysmal subarachnoid hemorrhage. Journal of the Medical Association of Thailand. Vol 99, (2016), p.S47-S53. Retrieved from: https://hdl.handle.net/20.500.14740/5362

Title

Lumbar drainage and low rate of permanent shunt insertion after treating aneurysmal subarachnoid hemorrhage

Author(s)

Boonyawanakij T.
 Tirakotai W.
 Liengudom A.

Abstract

Objective: This study investigated the predictive factors contributing to shunt-dependent hydrocephalus and the rate of shunt requirement in a ruptured aneurysmal subarachnoid hemorrhage. The factors related to short-term clinical outcomes were also determined. Material and Method: A retrospective review was conducted of 200 patients who underwent surgical clipping of ruptured aneurysmal subarachnoid hemorrhage based on protocols of CSF drainage at Prasat Neurological Institute (PNI) between January 2008 and February 2010. Patient demographic, Glasgow Coma Score (GCS), Hunt and Hess (H&H) grade, Fisher’s grade and Glasgow Outcome Scale (GOS) were evaluated. The rate of shunt requirement was analyzed. PNI score was designed for predicting shunt requirement. Results: Two hundred patients who underwent surgical clipping aneurysm consisted of 86 males and 114 females aged ranging from 34-78 years (Mean 56 years). The patients were divided into two groups by treatment protocols; 164 patients (82%) in the first group were operated using supraorbital craniotomy (SOC) with a pre-operative spinal drain. Thirty-six patients (18%) in the second group were operated using mini-open craniotomy and without pre-operative spinal drain. Three patients (1.5%) required a permanent shunts and all of them had full PNI Score (PNI score = 7) (p<0.001). In all, 189 patients (94.5%) with high preoperative GCS 9 (p<0.001) had satisfactory surgical outcomes (GOS 4&5). Conclusion: This study demonstrated the decreased rate of permanent shunts in patients with ruptured aneurysmal SAH who were treated under the PNI protocol. A factor that effectively predicted shunt-dependency was the PNI score equivalent to 7. © 2016, Medical Association of Thailand. All rights reserved.

Subject(s)

Adult
 Aged
 Article
 Brain artery aneurysm rupture
 Brain ventricle peritoneum shunt
 Cerebrospinal fluid drainage
 Computer assisted tomography
 Craniotomy
 Female
 Glasgow coma scale
 Glasgow outcome scale
 Human
 Hydrocephalus
 Intracranial pressure
 Major clinical study
 Male
 Outcome assessment
 Postoperative complication
 Retrospective study
 Spinal drain infection
 Subarachnoid hemorrhage
 Vasospasm
 Aneurysm rupture
 Cerebrospinal fluid shunting
 Complication
 Middle aged
 Procedures
 Prostheses and orthoses
 Risk factor
 Subarachnoid hemorrhage
 Adult
 Aged
 Aneurysm, Ruptured
 Cerebrospinal Fluid Shunts
 Drainage
 Female
 Glasgow Outcome Scale
 Humans
 Male
 Middle Aged
 Prostheses and Implants
 Retrospective Studies
 Risk Factors
 Subarachnoid Hemorrhage

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URI

https://hdl.handle.net/20.500.14740/5362

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Scopus: Year 1983-2021

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