The Clinical Study Of The Relationship Between Lumbar Drainage And Precent Shunt-dependent Hydrocephalus For Aneurysmal Subarachnoid Hemorrhage

Lumbar CSF drainage after aneurysmal SAH (aSAH) has been widely performedto prevent cerebral vasospasm and shunt-dependent hydrocephalus in many institutions. However, the study of influencing factory analysis of lumbar drainage is lack. In this study, we investigate which factors in lumbar drainage influence shunt-dependent hydrocephalus after aSAH in good-grade patients. Materials and methods:80subjects with good-grade aSAH from January,2008to December,2008wereadmitted to our department. All patients were performed lumbar drainage during the operation. Results are described in (X±SEM), statistical analysis was using SPSS16.0software, classification data was using chi-square test, continuous data was using Mann-Whitney U test. A P value of less than0.05was considered significant.Results:Fifteen patients (18.75%) developed shunt-dependent hydrocephalus, including6male (16.67%) and9female (20.45%)(P>0.05). In group of hydrocephalus, the average age is53.87±2.42years old, whereas in group of non-hydrocephalus, the average age is52.68±1.32years old (P>0.05). The Hunt-Hess grades of15patients were as follows:grade Ⅰ,1(12.5%); grade Ⅱ,6(17.65%); and grade Ⅲ,8(27.27%)(P<0.05). In hydrocephalus group, lumbar drainage lasted for11.4±1.67d, nevertheless, in non-hydrocephalus group, lumbar drainage lasted for9.17±0.42d (P>0.05).15patients in the shunt-depended hydrocephalus group included11aneurysms of anterior circulation (11/71,15.49%) and4aneurysms of posterior circulation (4/9,44.44%)(P<0.05). In51clipped patients,8patients developed hydrocephalus (15.69%), whereas in29coil embolism patients,7patients developed hydrocephalus,(24.14%)(P>0.05). In14patients with acute hydrocephalus,9patients ultimately developed shunt-depended hydrocephalus (64.29%). However, in66patients without acute hydrocephalus,6patients required shunt (9.09%)(P<0.001). Among4patients, who presented with intraventricular hemorrhage (IVH),2patients required ventriculoperitoneal shunt after4months. Although lumbar drainage was used to treat aSAH, patients with high Hunt andHess grade, IVH, aneurysms of anterior circulation, acute hydrocephalus are more likely to develop shunt-depended hydrocephalus. However, age, gender, drainage days, and treatment method of aneurysm (clipping or coil embolism) are not different significantly between the groups of shunt-depended hydrocephalus and non-hydrocephalus.