title: The Role of Fenestration of the Lamina Terminalis on Symptomatic Vasospasm After Aneurysmal Subarachnoid Hemorrhage: A Clinical Research.
abstract: OBJECTIVE
  To compare the beneficial effects of cisternal blood clot evacuation with or without microsurgical fenestration of the lamina terminalis (LT) on symptomatic vasospasm during the course of aneurysmal subarachnoid hemorrhage.
  
  
  METHODS
  This was a clinical, retrospective study that included 72 patients with aneurysmal subarachnoid hemorrhage (aSAH). The patient group that underwent aneurysm clipping with only extensive cisternal drainage of the subarachnoid blood clot was defined as the non fenestrated lamina terminalis group (NonFLT group, n=39). The patient group that underwent aneurysm clipping with extensive cisternal drainage of the subarachnoid blood clot combined with microsurgical fenestration of LT was defined as the fenestrated lamina terminalis group (FLT group, n=33). All patients were operated by the same experienced neurovascular surgeon, the senior author of this article (MEU), and his colleagues. New cerebral infarct development was determined with computed tomography, Glasgow Outcome Score (GOS), clinical vasospasm rate and Hunt-Hess scale (H&H) grade before and after surgery and duration of hospital stay of the patients were assessed and compared.
  
  
  RESULTS
  A favorable clinical outcome was obtained from 51.2% of the NonFLT group patients and 72.66% of the FLT group patients. And FLT group patients have better GOS and H&H grade. Clinical vasospasm rate and duration of hospital stay were also significantly reduced in FLT group patients.
  
  
  CONCLUSIONS
  Wide fenestration of lamina terminalis as a cerebrospinal fluid diversion technique may be very beneficial in the surgical treatment of aneurysmal SAH.
authors.affiliation: Serik State Hospital, Department of Neurosurgery, Antalya, Turkey.
authors.forename: Sahika Liva
authors.initials: SL
authors.lastname: Cengiz
authors.forename: Mustafa Kemal
authors.initials: MK
authors.lastname: Ilik
authors.forename: Fatih
authors.initials: F
authors.lastname: Erdi
authors.forename: Mehmet Erkan
authors.initials: ME
authors.lastname: Ustun
mesh_terms: D000328:Adult; D000368:Aged; D002544:Cerebral Infarction / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007031:Hypothalamus / Q000601:surgery*; D002532:Intracranial Aneurysm / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000601:surgery*