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J Neurol Surg B Skull Base
DOI: 10.1055/a-2436-8355
Original Article

Single Institution Experience with Lumbar Drainage and Subarachnoid Hemorrhage

Authors

  • William S. Coggins

    1   Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

  • Lauren E. Banko

    2   School of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

  • Purav Chokhani

    2   School of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

  • Elise G. Rushing

    2   School of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

  • Julie Necarsulmer

    3   School of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States

  • Deanna Sasaki-Adams

    1   Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

Funding Research reported in this publication was supported by the UAMS Translational Research Institute (TRI) and the National Center for Advancing Translational Sciences of the National Institutes of Health under award numbers UL1 TR003107, KL2 TR003108, and TL1 TR003109. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Abstract

Introduction In our article, we evaluate the effect of lumbar drainage on delayed cerebral ischemia and requirements for permanent cerebrospinal fluid diversion in patients with aneurysmal subarachnoid hemorrhage.

Methods We performed a retrospective cohort study from 2014 to 2023 at the University of Arkansas for Medical Sciences (UAMS) examining factors associated with patients (n = 150) who had aneurysmal subarachnoid hemorrhage and a lumbar drain placed. The main outcomes examined were incidence of delayed cerebral ischemia, need for permanent cerebrospinal fluid diversion, and neurologic outcomes at discharge that were compared to currently published standards.

Results We failed to appreciate a reduced occurrence of delayed cerebral ischemia (37.3% with the current literature supporting rates of 20–30%); however, we did find a low rate of requiring permanent cerebrospinal fluid diversion (12% compared to 10–20% in the current literature) with overall good neurologic outcomes at discharge (∼69% of patients had a Glasgow Outcome Scale [GOS] of 4–5 at discharge). Patients with GOS ≥ 4 at discharge were noted to be more likely to have more days or lumbar drainage and less likely to be older than 65 years, have had an external ventricular drain placed, and have experienced delayed cerebral ischemia.

Conclusion Lumbar drainage is a potentially useful adjunct in the management of secondary neurologic injury in subarachnoid hemorrhage.

Keywords

lumbar drain - subarachnoid hemorrhage - vasospasm - delayed cerebral ischemia - aneurysm

Previous Presentation

Poster Presentation at the 2024 North American Skull Base Society (NASBS) Annual Meeting.


Author's Contribution

Study conception, design, and search strategy were developed by W.S.C. and D.S.A. Data extraction was done by W.S.C., P.C., L.E.B., and E.G.R. Data analysis, interpretation, and manuscript production were done by all the authors. All the authors had full access to data included in this manuscript and approved its submission.




Publikationsverlauf

Eingereicht: 10. April 2024

Angenommen: 06. Oktober 2024

Accepted Manuscript online:
08. Oktober 2024

Artikel online veröffentlicht:
30. Oktober 2024

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