Lumbar drainage after subarachnoid hemorrhage: does it reduce vasospasm and delayed hydrocephalus?
- R. Loch Macdonald
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A resurgence of interest in lumbar drainage for prevention of cerebral vasospasm after SAH followed the report of Schmidt et al., from Utah . They studied patients with aneurysmal subarachnoid hemorrhage (SAH) managed contemporaneously at one center. One surgeon used lumbar drainage routinely while the others did not and while the study was not randomized, the call schedule and thus time when that neurosurgeon admitted patients, led to some degree of random allocation of patients to a surgeon who did or did not use lumbar drainage. The incidence of symptomatic vasospasm was decreased significantly from 51% in 86 patients compared with17% in 81 cases undergoing lumbar drainage. Quite remarkable reductions in need for angioplasty and in infarction from vasospasm also were noted. As confirmed in the current study, complications with lumbar drainage were rare.
The present report from the University of Mississippi in this issue of Neurocritical Care describes lumbar drainage in 25 patient ...
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- Lumbar drainage after subarachnoid hemorrhage: does it reduce vasospasm and delayed hydrocephalus?
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- 1. St. Michael’s Hospital and University of Toronto, 30 Bond Street, Toronto, ON, Canada, M5B 1W8