title: Intracerebral hemorrhage with severe ventricular involvement: lumbar drainage for communicating hydrocephalus.
abstract: OBJECTIVE
  The objective was to analyze the feasibility of a lumbar drainage (LD) for a communicating malresorptive hydrocephalus in patients with supratentorial hemorrhage (intracerebral hemorrhage) accompanied by severe ventricular involvement (intraventricular hemorrhage) who required an external ventricular drain (EVD).
  
  
  METHODS
  In this retrospective study, 16 patients received an EVD and concurrent LD and were compared with 39 historical patients treated with EVD alone. The duration of required EVD and need for permanent ventriculoperitoneal-shunt were analyzed.
  
  
  RESULTS
  LD was inserted after 12 (4 to 18) days. In LD-treated patients, the LD was capable to replace repeated EVD exchanges, resulting in a shorter EVD-duration (12 versus 16 days) compared with patients treated with EVD alone. The overall duration of extracorporal cerebrospinal fluid drainage was longer (16 days EVD versus 21 days EVD+LD) and the frequency of ventriculoperitoneal-shunt lower (18.75% versus 33%; P<0.03) in LD-treated patients.
  
  
  CONCLUSIONS
  Our data suggest that LD is safe and feasible for treatment of nonpersistent communicating hydrocephalus after intracerebral hemorrhage. After adequate treatment of the occlusive hydrocephalus using an EVD in the acute phase, LD discloses an alternative for further extracorporal cerebrospinal fluid drainage.
authors.affiliation: Department of Neurology, University of Erlangen, Germany. Hagen.Huttner@neuro.imed.uni-erlangen.de
authors.forename: Hagen B
authors.initials: HB
authors.lastname: Huttner
authors.forename: Simon
authors.initials: S
authors.lastname: Nagel
authors.forename: Elena
authors.initials: E
authors.lastname: Tognoni
authors.forename: Martin
authors.initials: M
authors.lastname: Köhrmann
authors.forename: Eric
authors.initials: E
authors.lastname: Jüttler
authors.forename: Berk
authors.initials: B
authors.lastname: Orakcioglu
authors.forename: Peter D
authors.initials: PD
authors.lastname: Schellinger
authors.forename: Stefan
authors.initials: S
authors.lastname: Schwab
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bardutzky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000503:physiopathology; D002555:Cerebrospinal Fluid / Q000502:physiology; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D020547:Lateral Ventricles / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013129:Spinal Puncture / Q000379:methods / Q000592:standards / Q000639:trends*; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects; D014696:Ventriculostomy / Q000009:adverse effects