[Reasons against lumbar puncture diagnosis with cerebrospinal fluid drainage in subarachnoid hemorrhage].
The necessity of cerebral angiography or angio-MRI was assessed in patients with thunderclap headache in whom subarachnoid haemorrhage had been ruled out on CT findings. In this cases the cerebrospinal fluid examination could be dangerous because could reduce the intracranial pressure with consequent risk of aneurysm rupture. CSF drainage, although, improves the clinical conditions and the symptoms of the patients, seems to not reduce the incidence of permanent neurological deficits caused by vasospasm; on the contrary, it increases the incidence of hydrocephalus requiring shunt procedures. We conclude that routine ventriculostomy with external ventricular drainage should be considered for all patients with altered sensorium and acute hyrocephalus following subarachnoid haemorrhage, with improvement in outcome.
Dipartimento di Emergenza, Ospedale Cardarelli, Napoli.
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D006801:Humans; D013129:Spinal Puncture / Q000009:adverse effects; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid / Q000175:diagnosis*
Le ragioni "contro" la rachicentesi diagnostica ed il drenaggio liquorale nell'ESA.