Techniques and complications of external lumbar drainage for normal pressure hydrocephalus.
OBJECTIVE
To describe our system of external lumbar drainage for normal pressure hydrocephalus, detail its complications, and discuss changes made to that system with time.


METHODS
This is a retrospective analysis of lumbar drainage in 233 consecutive patients with symptoms treated at the Brigham and Women's Hospital, Boston, MA, from February 2002 to August 2006.


RESULTS
The lumbar drain was successfully placed at the bedside in 223 of 233 patients; fluoroscopic guidance was used in 10 cases. There were significant complications in 3.0% of patients, including symptomatic subdural or subarachnoid hemorrhage in 1.7%, meningitis in 0.8%, and retained catheter in 0.4%. Another 5.2% of patients had minor problems, including nerve root irritation in 2.6%, low-pressure headache substantial enough to warrant premature removal of the drain in 1.7%, and local infection in 0.8%.


CONCLUSIONS
The rate of serious complications from external lumbar drainage for normal pressure hydrocephalus is low. It is hoped that continued evaluation of the procedure will lead to further reductions in the complication rate.
Governale
Lance S
LS
Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. lgovernale@partners.org
Fein
Nicole
N
Logsdon
Jessica
J
Black
Peter M
PM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000601:surgery*; D007297:Inpatients; D007902:Length of Stay; D008161:Lumbosacral Region; D008875:Middle Aged; D010045:Outpatients; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D013129:Spinal Puncture / Q000009:adverse effects; D016896:Treatment Outcome