Lumbar Drain for Temporary Cerebrospinal Fluid Diversion: Factors Related to the Risks of Complications at a University Hospital

Bakhshi, Saqib Kamran; Suhail, Nawal; Mitha, Rida; Moazzam, Mujtaba; Zahid, Nida; Shamim, Muhammad Shahzad

doi:10.1016/j.wneu.2020.07.120

Cited by 18 publications

(19 citation statements)

References 11 publications

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“…It is a closed system using a subarachnoid spinal catheter for diverting CSF flow. The indications for LD in a general neurosurgery department are as follows: diagnosis and management of hydrocephalus, post-traumatic or postoperative CSF leakage, to reduce brain retraction before a cranial procedure, and prevent CSF fistula formation [11]. Despite the controversy about placement of LD in patients with CSF leakage, a number of studies have reported its benefit in comparison with only conservative management without a LD [2,5,12].…”

Section: Discussionmentioning

confidence: 99%

“…Subarachnoid LD insertion is a quite invasive procedure in itself, and it can cause some problems such as low-pressure headache, lumbosacral radiculopathy, CSF pooling adjacent to the lumbosacral space, and serious complication such as meningitis, pneumocephalus, and subdural hematoma [11,13,14]. Several reports have cited tension pneumocephalus as a severe complication resulting in transtentorial herniation.…”

Section: Discussionmentioning

confidence: 99%

“…Because of this serious problem, CSF must be drained continuously at a constant rate. In case of meningitis, it is known to be significantly associated with the duration of LD placement and minimal manipulation [11,16]. Liang et al [17] reported that keeping the LD for more than four days was the most important risk factor for infectious problems.…”

Section: Discussionmentioning

confidence: 99%

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The diagnosis of cerebrospinal fluid leakage after microvascular decompression surgery and management via lumbar drain

Seo

Park

Lee

et al. 2022

J Korean Ster Func Neurosurg

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Objective: In posterior fossa surgery such as microvascular decompression (MVD), cerebrospinal fluid (CSF) leakage is a crucial problem. In this study, we explored the accurate diagnosis and effective non-surgical management of postoperative CSF leakage.Methods: We reviewed 749 patients who underwent MVD surgery from August 2018 to April 2022. Although we significantly reduced the CSF leakage problem by using the triple-layer closing technique (TLCT), CSF leakage was still a problem in a few cases. We managed these patients with the same diagnostic flow and treatment regimen using a lumbar drain (LD).Results: Among the 749 patients in the cohort, 11 (1.4%) had CSF leakage, and each of those cases presented with rhinorrhea. Five patients (45.5%) had the symptom on the first day, two patients (18.2%) on the second day, one patient (9.1%) on the third day, and three patients (27.3%) on the fifth day after surgery. After conservative treatment including CSF drainage via LD for 5.4 days on average, none of the patients had recurrent symptoms suggesting CSF leakage; thus, there was no need for wound repair surgery.Conclusion: Despite diligent attempts to prevent CSF leakage in open microsurgery, leaks inevitably occur in some cases and are more frequent in posterior fossa surgery. Although we cannot fully prevent leakage, we should limit the complication to ensure that it does not progress into other severe problems, such as meningitis. A closing technique such as TLCT is useful, but the early diagnosis and management of CSF leakage with LD is also important.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The diagnosis of cerebrospinal fluid leakage after microvascular decompression surgery and management via lumbar drain

Seo

Park

Lee

et al. 2022

J Korean Ster Func Neurosurg

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“…We do not use a systematic CSF lumbar diversion because of the potential complications due to this dispositive [20]. We believe that CSF leakage is mainly caused by the expulsion of the sellar packing.…”

Section: Csf Leakage and Recurrencementioning

confidence: 99%

Fully endoscopic endonasal approach for the treatment of intrasellar arachnoid cysts

et al. 2021

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HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

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“…Cerebral vasospasm (CVS) and rebleeding are all serious complications in the early stage after aSAH and can cause high mortality. In their study of 211 patients, Bakhshi et al (4) observed the adverse effects of LCDF, and found iatrogenic spinal fluid leakage and Jiaxing meningocele to be the most common complications. Pathogens of meningitis include E. coli and Pseudomonas aeruginosa.…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of the effect of continuous cerebrospinal fluid drainage on keyhole surgery during the perioperative period

Feng¹,

Liu²,

Cao³

et al. 2021

Ann Palliat Med

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Lumbar Drain for Temporary Cerebrospinal Fluid Diversion: Factors Related to the Risks of Complications at a University Hospital

Cited by 18 publications

References 11 publications

The diagnosis of cerebrospinal fluid leakage after microvascular decompression surgery and management via lumbar drain

The diagnosis of cerebrospinal fluid leakage after microvascular decompression surgery and management via lumbar drain

Fully endoscopic endonasal approach for the treatment of intrasellar arachnoid cysts

Systematic review and meta-analysis of the effect of continuous cerebrospinal fluid drainage on keyhole surgery during the perioperative period

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