title: Duration of cerebrospinal fluid drainage in patients with aneurysmal subarachnoid hemorrhage for prevention of symptomatic vasospasm and late hydrocephalus.
abstract: The optimal duration of cerebrospinal fluid (CSF) drainage after acute aneurysm surgery is unclear. The association between the occurrence of symptomatic vasospasm or late hydrocephalus and the duration of CSF drainage was investigated using multiple logistic analysis in 95 consecutive patients with aneurysmal subarachnoid hemorrhage who underwent surgery within 72 hours after onset. The duration of drainage was significantly related to the occurrence of symptomatic vasospasm and late hydrocephalus. The cut-off values of the duration of drainage for preventing symptomatic vasospasm and late hydrocephalus were 11 days (adjusted odds ratio 0.347, 95% confidence interval 0.135-0.889, p = 0.0274) and 6 days (adjusted odds ratio 4.86, 95% confidence interval 1.46-16.2, p = 0.0099), respectively. Prevention of both symptomatic vasospasm and late hydrocephalus is not possible without additional procedures such as cisternal irrigation using fibrinolytic agents.
authors.affiliation: Department of Neurosurgery, Toyama Medical and Pharmaceutical University, 2630 Sugutani, Toyama 930-0194, Japan. yhira@ms.toyama-mpu.ac.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hirashima
authors.forename: Masanori
authors.initials: M
authors.lastname: Kurimoto
authors.forename: Nakamasa
authors.initials: N
authors.lastname: Hayashi
authors.forename: Kimiko
authors.initials: K
authors.lastname: Umemura
authors.forename: Emiko
authors.initials: E
authors.lastname: Hori
authors.forename: Hideki
authors.initials: H
authors.lastname: Origasa
authors.forename: Shunro
authors.initials: S
authors.lastname: Endo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000209:etiology / Q000517:prevention & control*; D017287:Ventriculoperitoneal Shunt