Influence of Routine Intraoperative Ventricular Drainage on the Incidence of Aneurysmal Rebleeding
Journal of Korean Neurosurgical Society
;
: 18-23, 2004.
Artigo
em Coreano
| WPRIM
| ID: wpr-125064
ABSTRACT
OBJECTIVE:
Although there are several risk factors to which related intraoperative aneurymal bleeding, the relationship between ventricular drainage to aneurysmal rebleeding is still controversial. We investigate to define the relationship of an immediate ventricular drainage after craniotomies in predissection stage rerupture of aneurysms.METHODS:
Randomized prospective and retrospective analyses were performed on 197 consecutive patients with confirmed aneurysmal subarachnoid hemorrhage(SAH) who underwent aneurysmal clipping in acute stage during 5 years. The aneurysmal SAH patients were divided into two groups according to the use of intraoperative ventricular cerebrospinal fluid(CSF) drainage. Various variables including Hunt-Hess grade, Fisher grade, Glasgow coma scale, Glasgow outcome scale, location of aneurysms, and the presence of a "daughter" aneurysm and hydrocephalus were analyzed.RESULTS:
Regardless the drained CSF amount, the incidence of the intraoperative aneurysmal rerupture in predissection stage during aneurysmal clipping has not showed any difference in both groups. Depending on the presence of the acute hydrocephalus, the rerupture incidence in dissection stage during aneurysmal surgery was not statistically significant. However, the frequency of rebleeding in patients with ventriculostomy(66% of 24) was significantly higher than in hydrocephalic patients without ventriculostomy(25% of 27) and patients without acute hydrocephalus(22% of 110).CONCLUSION:
Routine intraoperative ventricular drainage does not increase the incidence of aneurysmal rebleeding and the more extensive arachnoid dissection is not necessary even during an early surgery. Moreover, it obtains an adequate intraoperative brain relaxation, which resulted in the decrease of retraction injury.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Aracnoide-Máter
/
Relaxamento
/
Hemorragia Subaracnóidea
/
Encéfalo
/
Escala de Coma de Glasgow
/
Drenagem
/
Incidência
/
Estudos Prospectivos
/
Estudos Retrospectivos
/
Fatores de Risco
Tipo de estudo:
Estudo de etiologia
/
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
Idioma:
Coreano
Revista:
Journal of Korean Neurosurgical Society
Ano de publicação:
2004
Tipo de documento:
Artigo
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