Comparison of ventricular drainage in poor grade patients after intracranial hemorrhage

Objectives: The selection of patients and treatment criteria for acute hydrocephalus and intracranial pressure (ICP) after intracranial hemorrhage remains unclear. In general neurosurgical practice, there is a tendency to use external ventricular drainage (EVD) for the patients. This study was under...

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Bibliographic Details
Published in:Neurological research (New York) 2005-09, Vol.27 (6), p.653-656
Main Authors: Yilmazlar, Selcuk, Abas, Faruk, Korfali, Ender
Format: Article
Language:English
Subjects:
ACUTE HYDROCEPHALUS
Adult
Aged
Aged, 80 and over
Bacterial Infections - etiology
Cerebral Ventricles - physiopathology
Cerebrospinal Fluid Shunts - adverse effects
EXTERNAL VENTRICULAR DRAINAGE
Female
Glasgow Coma Scale - statistics & numerical data
Humans
INFECTION
INTRACRANIAL HEMORRHAGE
Intracranial Hemorrhages - surgery
INTRACRANIAL PRESSURE
Intracranial Pressure - physiology
Male
Middle Aged
Monitoring, Physiologic - methods
MORTALITY
Postoperative Complications - etiology
Retrospective Studies
Treatment Outcome
VENTRICULO-PERITONEAL SHUNT
Ventriculoperitoneal Shunt - adverse effects
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Summary:Objectives: The selection of patients and treatment criteria for acute hydrocephalus and intracranial pressure (ICP) after intracranial hemorrhage remains unclear. In general neurosurgical practice, there is a tendency to use external ventricular drainage (EVD) for the patients. This study was undertaken to analyse the complications and efficiency of the different treatment modalities. Methods: The effects, complications and outcome of ventricular drainage on high ICP and hydrocephalus were analysed retrospectively in 109 patients with intracranial hemorrhage. All the patients were assessed using the Glasgow Coma Scale, computed tomography and ICP monitoring. We excluded patients over the GCS of 8. All patients underwent a procedure for ICP monitoring plus ventricular cerebrospinal fluid (CSF) drainage. Sixty-one patients were managed with one (single) EVD system; 12 patients needed two EVD systems consecutively, while 23 patients underwent an EVD procedure followed by permanent ventriculoperitoneal (VP) shunt insertion. Thirteen patients were treated only by VP shunt for ventricular drainage. The infection rate and outcome 9 months after hemorrhage were analysed. Results: The infection rates were 8.1% in the one-EVD group, 33.3% in the two-EVD group (one EVD versus two EVD, p
ISSN:0161-6412
1743-1328
DOI:10.1179/016164105X35657