Hayek Muhammad Ali, Roth Christian, Kaestner Stefanie, Deinsberger Wolfgang
Department of Stereotactic Neurosurgery, Uniclinic Magdeburg, Magdeburg, Germany.
Department of Neurology, Klinikum Kassel, Kassel, Germany.
J Neurol Surg A Cent Eur Neurosurg. 2017 May;78(3):227-230. doi: 10.1055/s-0036-1584813. Epub 2016 Jul 22.
The indication for and the timing of a permanent shunt operation in patients following acute hydrocephalus (HC) after subarachnoid hemorrhage (SAH) remains controversial because risk factors for chronic HC fail to predict permanent shunt dependency. The amount of cerebrospinal fluid (CSF) drained via an external ventricular drain (EVD) may predict shunt dependency. We conducted a retrospective study of our HC database from January 2006 to December 2011. All patients receiving an EVD due to acute HC after SAH were analyzed. The daily amount of drained CSF was documented until the EVD was removed or converted to a permanent shunt either immediately or during a follow-up period of 6 months. A total of 139 patients (48 male, 91 female; mean age: 57 ± 14 years) were eligible for the study. Mean duration of EVD was 16 ± 10 days (range: 4-60 days). A permanent shunt was necessary in 32% of cases ( = 45). The mean daily CSF volume was 139 ± 17 mL (range: 15-460 mL). Using repeated-measures analysis of variance, there was a significant difference of daily drained CSF volumes between both the groups in the first 15 days after the EVD. Our results suggest that the daily amount of external CSF drainage volume in the acute state of SAH might influence the development of HC.
对于蛛网膜下腔出血（SAH）后急性脑积水（HC）患者进行永久性分流手术的指征和时机仍存在争议，因为慢性HC的危险因素无法预测永久性分流依赖情况。通过外部脑室引流（EVD）排出的脑脊液（CSF）量可能预测分流依赖。我们对2006年1月至2011年12月期间的HC数据库进行了一项回顾性研究。分析了所有因SAH后急性HC接受EVD的患者。记录每日引流的CSF量，直至EVD被移除或立即或在6个月的随访期内转换为永久性分流。共有139例患者（48例男性，91例女性；平均年龄：57±14岁）符合研究条件。EVD的平均持续时间为16±10天（范围：4 - 60天）。32%的病例（n = 45）需要进行永久性分流。平均每日CSF量为139±17 mL（范围：15 - 460 mL）。使用重复测量方差分析，在EVD后的前15天内，两组之间每日引流的CSF量存在显著差异。我们的结果表明，SAH急性期外部CSF引流量可能会影响HC的发展。
