CSF Lumbar Drainage: A Safe Surgical Option in Refractory Intracranial Hypertension Associated with Acute Posttraumatic External Hydrocephalus

Manet, Romain; Schmidt, Eric; Vassal, François; Charier, David; Gergelé, Laurent

doi:10.1007/978-3-319-22533-3_11

Cited by 17 publications

(27 citation statements)

References 30 publications

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“…An elevated ICP, which results from primary injury or develop secondary insult, has been proved to be associated with poor outcomes after TBI [10,11]. Surgical management is often the treatment option for the TBI patients.…”

Section: Discussionmentioning

confidence: 99%

Size of bone flap in decompressive craniectomy: an analysis of complications and prognosis in traumatic brain injury

Luo

Pan

et al. 2019

Preprint

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Objective: To investigate association of size of bone flap with common complications and prognosis in traumatic brain injury. Methods: A retrospective analysis was performed in 108 TBI patients of Northern Jiangsu People's Hospital from January 2018 to March 2019. Patients’ gender, age, Glasgow Coma Scale at admisson, pupils reactivity to the light, size of bone flap, types of craniocerebral injuries and injury locations were recorded. Prognostic indicators including changes in hematoma volume and neurological status were extracted. Statistical methods were conducted to evaluate drug efficacy. Prognostic indicators including Glasgow Outcome Scale scores at discharge and GOS scores of 6 months after operation were extracted to evaluate surgical effcacy.Results : Postoperative complications such as encephalocele and subdural effusion were significantly associated with size of bone flap ( P <0.05). The incidence of encephalocele and SE increased with bone flap size in bone flap groups. Age, GCS at admisson, pupils reactivity to the light, and size of bone flap were shown significantly differences between prognosis groups ( P <0.05). By binary logistic regression, Age, pupils reactivity to the light, and the size of bone flap showed statistical significance ( P <0.05). Conclusion: Size of bone flap in decompressive craniectomy is a dependent factor to prognosis. Avoiding oversize craniectomy may bring less complications and positive prognosis.

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Section: Discussionmentioning

confidence: 99%

Size of bone flap in decompressive craniectomy: an analysis of complications and prognosis in traumatic brain injury

Luo

Pan

et al. 2019

Preprint

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“…Five studies were presented as observational studies: three retrospective [9,20,21]and two prospective [28,34]. Three studies utilised a mixed cohort of patients with TBI and aneurysmal subarachnoid haemorrhage (SAH) and/or intracerebral haemorrhage (ICH) [21,28,34] with six studies including only patients with TBI [1,9,19,20,22,37]. One study included only paediatric patients [19], seven studies included only adult patients [1, 9, 20-22, 28, 37] and one included adults and children [34].…”

Section: Study Selectionmentioning

confidence: 99%

External Lumbar Drainage for Refractory Intracranial Hypertension in Traumatic Brain Injury: A Systematic Review

Stevens

Soon

Chowdhury

et al. 2021

Preprint

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BackgroundExternal lumbar drainage remains a controversial therapy for medically refractory intracranial hypertension in patients with acute TBI. This systematic review sought to compile the available evidence for the efficacy and safety of the use of lumbar drains for ICP control. MethodsA systematic review of the literature was performed with the search and data extraction performed by two reviewers independently in duplicate.ResultsNine independent studies were identified enrolling 230 patients, 159 with TBI. Efficacy for ICP control was observed across all studies, with immediate and sustained effect, reducing medical therapy requirements. Lumbar drainage with medical therapy appears effective when used alone and as an adjunct to ventricular drainage. Safety reporting varied in quality. Cerebral herniation (with unclear relationship to lumbar drainage) was observed in 14/230 patients resulting in one incident of morbidity without adverse patient outcome. ConclusionsThe available data is generally poor in quality and volume, but supportive of efficacy of lumbar drainage for ICP control. Few reports of adverse outcome are suggestive of, but are insufficient to confirm, safety of use in the appropriate patient and clinical setting. Further large prospective observational studies are required to generate sufficient support of an acceptable safety profile.

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“…El diagnóstico se basa en los siguientes elementos: alto índice de sospecha cuando se presenta una patología como las citadas; presencia de HIC con cisternas presentes y conservación del buffer espacial, o los métodos no invasivos (medida ultrasonográfica de la vaina del nervio óptico o el Doppler transcraneal) detectan hallazgos sugestivos de HIC. En todos estos casos el DLE es de elección para el control de la HIC y debe ser considerado la primera medida a realizar (34)(35)(36)(37)(38) .…”

Section: Tratamiento De La Hic Con Cisternas Basales Presentesunclassified

“…Algunos autores, como Manet y colaboradores, agregan a estas condiciones el desarrollo gradual de colecciones subaracnoideas o subdurales localizadas en la cisura de Silvio o interhemisférica, o en los surcos de la convexidad. Esto se basa en el mecanismo fisiopatológico planteado por estos autores como causa de esta situación y que consiste en la denominada hidrocefalia externa (34)(35)(36) .…”

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Drenaje lumbar externo en la unidad de cuidados intensivos

Grille

Salle

Biestro

2020

RMU

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El drenaje lumbar externo es un procedimiento invasivo de extracción de líquido cefalorraquídeo del espacio espinal cuyo uso se ha incrementado en los últimos años en el contexto de la medicina neurocrítica. Si bien no es recomendado por las guías o consensos internacionales, tiene un lugar en el manejo de algunas situaciones clínicas específicas vinculadas a diferentes tipos de neuroinjuria grave. Se realiza una revisión no sistemática de la literatura, a lo que se suma la experiencia de los autores. Se plantean las principales indicaciones actuales, se detallan las características de su manejo en los distintos escenarios clínicos y se señalan las contraindicaciones y complicaciones del procedimiento.

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CSF Lumbar Drainage: A Safe Surgical Option in Refractory Intracranial Hypertension Associated with Acute Posttraumatic External Hydrocephalus

Cited by 17 publications

References 30 publications

Size of bone flap in decompressive craniectomy: an analysis of complications and prognosis in traumatic brain injury

Size of bone flap in decompressive craniectomy: an analysis of complications and prognosis in traumatic brain injury

External Lumbar Drainage for Refractory Intracranial Hypertension in Traumatic Brain Injury: A Systematic Review

Drenaje lumbar externo en la unidad de cuidados intensivos

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