The role of lumbar drainage in symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage
Li Li, Zhou Feng, Zhao Xuequn, Fang Bing, Chen Xianyi
Published 2015-12-01
Cite as Chin J Emerg Med, 2015,24(12): 1357-1363. DOI: 10.3760/cma.j.issn.1671-0282.2015.12.009
Abstract
ObjectiveTo investigate the risk factors of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage and evaluate the effect of lumbar drainage of cerebrospinal fluid on vasospasm.
MethodsIn this retrospective controlled-cohort study, 175 patients with aneurysmal subarachnoid hemorrhage met our study criteria between January 2012 and December 2013. By multi-factor regression analysis, gender, age, Hunt-Hess grade, modified Fisher grade and lumbar drainage were analyzed. The outcomes were assessed by the presence or absence of symptomatic cerebral vasospasm and vasospasm-related infarction, and the mean days of hospital stay and score of Glasgow Outcome Scale at 1-month follow-up.
ResultsSeveral factors affected the prognosis of subarachnoid hemorrhage. Lumbar drainage was a protective factor of symptomatic cerebral vasospasm (OR=0.243, 95% CI: 0.119 -0.497) and vasospasm-related infarction (OR=0.305, 95% CI: 0.154 -0.604). The patients with lumbar drainage had higher score of Glasgow Outcome Scale (P <0.05). But the patients with lumbar drainage had longer hospital stay (P <0.05).
ConclusionsLumbar drainage of cerebrospinal fluid after aneurysmal subarachnoid hemorrhage markedly reduced the risk of symptomatic cerebral vasospasm and improved outcome.
Key words:
Aneurysm; Subarachnoid hemorrhage; Symptomatic cerebral vasospasm; Vasospasm- related infarction; Sex; Age; Hunt-Hess grade; Fisher grade; Lumbar drainage
Contributor Information
Li Li
Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University, Hangzhou 310009, China
Zhou Feng
Zhao Xuequn
Fang Bing
Chen Xianyi
