The Role of Lumbar Drainage to Prevent Shunt-Dependent Hydrocephalus after Coil Embolization for Aneurysmal Subarachnoid Hemorrhage in Good-Grade Patients

• Published in: Journal of Korean Neurosurgical Society Vol. 48; no. 6; pp. 480 - 484
• Main Authors: Yong, Cho In, Hwang, Sung-Kyun, Kim, Sung-Hak
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Neurosurgical Society 01.12.2010; 대한신경외과학회
• Subjects: Clinical; 신경외과학; Coil embolization; Lumbar drainage; Hydrocephalus; Shunt
• ISSN: 2005-3711; 1598-7876; 1598-7876
• DOI: 10.3340/jkns.2010.48.6.480

To evaluate the role of lumbar drainage in the prevention of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by coil embolization in good-grade patients. One-hundred-thirty consecutive patients with aneurysmal subarachnoid hemorrhage in good-grade patients (Hunt & Hess grades I-III), who were treated by coil embolization between August 2004 and April 2010 were retrospectively evaluated. Poor-grade patients (Hunt & Hess grades IV and V), a history of head trauma preceding the development of headache, negative angiograms, primary subarachnoid hemorrhage (SAH), and loss to follow-up were excluded from the study. We assessed the effects on lumbar drainage on the risk of shunt-dependent hydrocephalus related to coil embolization in patients with ruptured intracranial aneurysms. One-hundred-twenty-six patients (96.9%) did not develop shunt-dependent hydrocephalus. The 2 patients (1.5%) who developed acute hydrocephalus treated with temporary external ventricular drainage did not require permanent shunt diversion. Overall, 4 patients (3.1%) required permanent shunt diversion; acute hydrocephalus developed in 2 patients (50%). There was no morbidity or mortality amongst the patients who underwent a permanent shunt procedure. Coil embolization of ruptured intracranial aneurysms may be associated with a lower risk for developing shunt-dependent hydrocephalus, possibly by active management of lumbar drainage, which may reflect less damage for cisternal anatomy than surgical clipping. Coil embolization might have an effect the long-term outcome and decision-making for ruptured intracranial aneurysms.