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Effect of lumbar drainage on incidence of shunt dependent hydrocephalus in patients with subarachnoid hemorrhage due to ruptured aneurysm who underwent coil embolization
Soung Bin Yim1, Yeongu Chung1, Pil Wook Chung2, Yu Sam Won1
1Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence  Yu Sam Won ,Tel: +82-2-2001-2450, Fax: +82-2-2001-2157 , Email: yusam.won@samsung.com
Received: August 31, 2018;  Accepted: September 10, 2018.  Published online: September 10, 2018.
ABSTRACT
Introduction Chronic or shunt dependent hydrocephalus (SDH) is a hydrocephalus that develops at two weeks or more after onset of subarachnoid hemorrhage (SAH). A recent study has reported that lumbar drainage can reduce the incidence of SDH after coil embolization of aneurysmal SAH, different from previous studies. The purpose of this study was to determine the effect of lumbar drainage on incidence of SDH after SAH in patients who underwent coil embolization.
Materials and Methods
A total of 113 patients who were treated with coil embolization only for SAH from January 2006 to August 2013 were investigated. They were randomly allocated into two groups depending on the management protocol that included lumbar drainage insertion or not. SDH was defined based on Evans` index and bicaudate index on computed tomography (CT). We compared incidence of SDH according to the presence and absence of lumbar drainage. Results Lumbar drainage was performed in 53 (46.9%) patients. Of these patients, 14 had SDH measured by Evans` index (p = 0.089) while seven had SDH measured by bicaudate index (p = 0.007). Ventriculoperitoneal shunt (VPS) was performed in five patients of lumbar drainage group (p = 0.258).
Conclusion
Lumbar drainage insertion in patients who underwent coil embolization reduced the risk of SDH after SAH.
Key words: Subarachnoid hemorrhage; Endovascular procedures; Ventriculoperitoneal shunt; Hydrocephalus
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