on November 22, 2006
Published online before print November 22, 2006, doi: 10.1161/01.STR.0000251795.02560.62
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Submitted on May 22, 2006
From the Department of Neurology (H.B.H., M.K., P.D.S., S.S., J.B.), University of Erlangen, Germany; and the Departments of Neurology (H.B.H., S.N., E.T., E.J.) and Neurosurgery (B.O.), University of Heidelberg, Germany. * To whom correspondence should be addressed. E-mail: Hagen.Huttner{at}neuro.imed.uni-erlangen.de.
Background and Purpose--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. Conclusion--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.
Revised on July 29, 2006
Accepted on August 25, 2006
Intracerebral Hemorrhage With Severe Ventricular Involvement. Lumbar Drainage for Communicating Hydrocephalus
Hagen B. Huttner MD*;
Key words: communicating hydrocephalus • intracerebral hemorrhage • intraventricular hemorrhage • lumbar drainage • therapy • treatment
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