Della Pepa G M, Scerrati A, Albanese A, Marchese E, Maira G, Sabatino G
Institute of Neurosurgery, Catholic University of Rome, Largo A. Gemelli 8, 00168, Italy.
Institute of Neurosurgery, Catholic University of Rome, Largo A. Gemelli 8, 00168, Italy.
Clin Neurol Neurosurg. 2014 Sep;124:97-101. doi: 10.1016/j.clineuro.2014.06.030. Epub 2014 Jun 28.
Cerebral vasospasm (VS) is one of the factors that can most significantly worsen the prognosis after aneurysmal subarachnoid hemorrhage (SAH). A substantial body of evidence supports the idea that CSF diversion could prevent VS, even if this issue is still much debated. External ventricular drainage (EVD) is the recommended procedure for post-hemorrhagic hydrocephalus. In this study we analyzed whether EVD, placed for acute hydrocephalus, is effective in reducing the incidence of clinical and radiological cerebral vasospasm in patients who underwent endovascular treatment for aneurysmal SAH.
We retrospectively studied the incidence of radiologically confirmed VS in 141 patients treated endovascularly for aneurysmal SAH: 80 underwent EVD for hydrocephalus, 61 did not undergo EVD.
VS occurred in 8.75% of cases (7 patients) in the first groups, while in 22.95% (14 patients) in the second group. In addition, patients not treated with EVD display a prevalence of VS in lower Fisher grades compared to the other group.
Our data indicate that CSF drainage reduces the risk of vasospasms in patients with endovascular treatment for aneurysmal SAH.
脑血管痉挛（VS）是可使动脉瘤性蛛网膜下腔出血（SAH）后预后显著恶化的因素之一。大量证据支持脑脊液引流可预防VS这一观点，即便该问题仍存在诸多争议。脑室外引流（EVD）是出血后脑积水的推荐治疗方法。在本研究中，我们分析了因急性脑积水而放置的EVD对于接受动脉瘤性SAH血管内治疗的患者，在降低临床和放射学脑血管痉挛发生率方面是否有效。
我们回顾性研究了141例接受动脉瘤性SAH血管内治疗患者经放射学证实的VS发生率：80例因脑积水接受了EVD，61例未接受EVD。
第一组中8.75%的病例（7例患者）发生了VS，而第二组为22.95%（14例患者）。此外，与另一组相比，未接受EVD治疗的患者在较低Fisher分级中VS患病率更高。
我们的数据表明，脑脊液引流可降低接受动脉瘤性SAH血管内治疗患者发生血管痉挛的风险。
