[A study of continuous cerebrospinal fluid drainage in patients with subarachnoid hemorrhage].
The influences of continuous cerebrospinal fluid (CSF) drainage on vasospasm and hydrocephalus were analyzed retrospectively in 150 patients with subarachnoid hemorrhage (SAH) due to ruptured intracranial aneurysms (32 cases of grade 1, 85 cases of grade 2, and 33 cases of grade 3 by the Hunt and Hess classification). One hundred and seven of these cases received CSF drainage (cisternal, ventricular, lumbar, or a combination of these). The volume of CSF drainage within the first week after onset was 975 +/- 513 ml (mean +/- SD). The total volume of CSF drainage was 2063 +/- 1635 ml (mean +/- SD). The duration of CSF drainage was 10.6 +/- 6.8 days (mean +/- SD). Ten of 46 cases given no drainage within the first week after onset, nine of 55 cases with a drainage volume of less than 1000 ml within the first week, and 24 of 49 cases with a drainage volume of more than 1000 ml within the first week showed vasospasm. There was a statistically significant dose-response (drainage volume-vasospasm) relationship (p less than 0.005, Mantel extension method). Four of 43 cases with no drainage, 26 of 67 cases with a total drainage volume of less than 2000 ml, and 24 of 40 cases with a total drainage volume of more than 2000 ml developed hydrocephalus. There was a statistically significant dose-response (drainage volume-hydrocephalus) relationship (p less than 0.005, Mantel extension method). Vasospasm and hydrocephalus were statistically associated (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
Kasuya
H
H
Department of Neurosurgery, Tokyo Women's Medical College, Japan.
Shimizu
T
T
Okada
T
T
Takahashi
K
K
Summerville
T
T
Kitamura
K
K
D000328:Adult; D000368:Aged; D004322:Drainage / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D002532:Intracranial Aneurysm / Q000601:surgery; D002546:Ischemic Attack, Transient / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid / Q000601:surgery*; D013997:Time Factors