Significance of an Early Clinical Course during the External Ventricular Drainage in Thalamic Hemorrhage
Journal of Korean Neurosurgical Society
;
: 81-87, 2004.
Article
in Korean
| WPRIM
| ID: wpr-184469
ABSTRACT
OBJECTIVE:
The purpose of this study is to investigate the significance of an early clinical course during the external ventricular drainage(EVD) in patients with thal amic hemorrhage.METHODS:
During the last 11 years(1990-2000), a hundred patients with thalamic hemorrhage who underwent EVD were studied. Thirty-four patients underwent temporary closing of EVD at the mean interval of 4.5 days after EVD. The clinical course was divided into 3 groups according to change of Glasgow Coma Scale(GCS) scores of 2 or more within 3 days after EVD compared with those just before EVD deteriorated, unchanged, and improved.RESULTS:
The factors affecting mortality were unchanged(odds ratio [OR] 0.05, 95% confidence interval [CI]0.01-0.38, p=0.0028) and deteriorated clinical course(OR 0.06, 95% CI 0.01-0.38, p=0.0033), GCS scores at the time of admission(OR 1.3, 95% CI 1.02-1.66, p=0.0346), amount of hematoma(OR 0.91, 95% CI 0.83-1.00, p=0.0461) and hematoma enlargement(OR 0.06, 95% CI 0.01-0.65, p=0.0198). The factor affecting the early clinical deterioration was the hematoma enlargement(OR 0.11, 95% CI 0.03-0.38, p=0.0005). The shunt operation was predicted in patients who showed the clinical improvement after EVD followed by the clinical deterioration within 48 hours after temporary closing of EVD.CONCLUSION:
It is suggested that an early clinical course during the maintenance of EVD is important to predict mortality and necessity of shunt operation.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Drainage
/
Mortality
/
Coma
/
Hematoma
/
Hemorrhage
Type of study:
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
Journal of Korean Neurosurgical Society
Year:
2004
Type:
Article
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