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Abstract - Original Article

J Cerebrovasc Endovasc Neurosurg. 2020 22(2): 53-64
The Journal of Cerebrovascular and Endovascular Neurosurgery
      
 
Risk factors of postoperative remote intracerebral hemorrhage after craniotomy for ruptured cerebral aneurysms
Insu Lee1, Cheol Wan Park1,2, Chan Jong You1,2, Dae Han Choi1,2, Kwangwoo Park1,2, Young Bo Kim1, Woo Kyung Kim1, Gi-Taek Yee1, Myeong-Jin Kim1, Eun Young Kim1
1Department of Neurosurgery, Gil Medical Center, Gachon University, Incheon, Korea , 2Department of Emergency Medicine, Section of Critical Care Medicine, Gil Medical Center, Gachon University, Incheon, Korea

Objective: We aimed to identify the relation between perioperative cerebrospinal fluid (CSF) drain through lumbar drainage (LD) and development of postoperative (POP) remote intracerebral hemorrhage (rICH) in craniotomy to treat ruptured intracranial aneurysms. Methods: We retrospectively reviewed consecutive patients who underwent craniotomy for ruptured cerebral aneurysms at the authors institution between 1998 and 2004. We subsequently compared the incidence and characteristics of POP rICH between the patients who had a perioperative LD and those who did not. All statistical analyses were conducted using the software package SPSS 19.0 (SPSS Inc., Chicago, IL, USA). A p value of <0.05 was considered statistically significant. Results: We enrolled 688 patients, of which 80 patients (11.6%) received perioperative LD, and 608 did not. LD and non-LD groups were comparable because although clinical characteristics of the two groups were significantly different considering history of hypertension, timing of surgery, and closed system negative pressure suction drain (SD) placement, none of these three variables was an independent risk factor associated with POP rICH in multivariate analysis. POP rICH incidence was significantly higher in the LD goup (12.5%) than non-LD group (0.8%) (p=0.000) in univariate analysis. LD placement was the only independent risk factor associated with the development of rICH in multivariate logistic regression analysis. Conclusions: POP rICH incidence was significantly higher in patients who were managed with perioperative LD than in those who did not. LD insertion in craniotomy for ruptured intracranial aneurysm, should be closely monitored to address the occurrence of POP rICH.
 
Key words : Intracranial aneurysm, Postoperative hemorrhage, Cerebrospinal fluid, Cerebrospinal fluid leak
 
 
    
 
 
 

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