Relationship between external ventricular drain clamp trials and ventriculoperitoneal shunt insertion following nontraumatic subarachnoid hemorrhage: a single-center study
| العنوان: | Relationship between external ventricular drain clamp trials and ventriculoperitoneal shunt insertion following nontraumatic subarachnoid hemorrhage: a single-center study |
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| المؤلفون: | Nimer Adeeb, Julie Mayeku, Yaw Tachie-Baffour, Christopher S. Ogilvy, Abdulrahman Y. Alturki, Raghav Gupta, Christoph J. Griessenauer, Luis C. Ascanio, Philip G.R. Schmalz, Ajith J. Thomas, Justin M. Moore, Ranjit Thomas |
| المصدر: | Journal of Neurosurgery. 130:956-962 |
| بيانات النشر: | Journal of Neurosurgery Publishing Group (JNSPG), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Subarachnoid hemorrhage, Critical Care, Single Center, Ventriculoperitoneal Shunt, 03 medical and health sciences, 0302 clinical medicine, Aneurysm, medicine, Humans, Device Removal, Aged, Retrospective Studies, Aged, 80 and over, 030504 nursing, business.industry, General Medicine, Length of Stay, Middle Aged, Subarachnoid Hemorrhage, Surgical Instruments, medicine.disease, Hydrocephalus, Surgery, Shunt (medical), Treatment Outcome, Clamp, Etiology, Drainage, Female, 0305 other medical science, business, 030217 neurology & neurosurgery, External ventricular drain |
| الوصف: | OBJECTIVECurrently, there is no established standard regarding the ideal number of external ventricular drain (EVD) clamp trials performed before ventriculoperitoneal (VP) shunt insertion following nontraumatic subarachnoid hemorrhage (SAH). In this study, the authors aimed to evaluate this relationship.METHODSA retrospective review of all patients presenting with SAH between July 2007 and December 2016 was performed. Patients with SAH who had received an EVD within the first 24 hours of hospital admission and had undergone at least 1 clamp trial prior to EVD removal were eligible for inclusion in the study. Patient demographics, clinical presentations, SAH etiologies and grades, clamp trial data, hospital lengths of stay, and functional outcomes were recorded.RESULTSOne hundred fourteen patients with nontraumatic SAH complicated by posthemorrhagic hydrocephalus were included in the study. The median patient age was 57 years (range 28–90 years), with a male/female ratio of 1:1.7. A ruptured aneurysm was the underlying etiology of SAH in 79.8% of patients. A majority of patients (69.4%) had a Hunt and Hess grade III–V on admission. The median number of clamp trials performed was 2 (range 1–6). A VP shunt was required in 40.4% of patients. In those who underwent 2 and 3 clamp trials, 60% and 38.9%, respectively, did not require subsequent VP shunt placement.CONCLUSIONSSurgical placement of a VP shunt is associated with complications. Clamp trials are routinely performed before making the decision to insert a shunt. In the present study, the authors found that a significant percentage of patients passed their second and third clamp trials without requiring subsequent shunt insertion. These data support performing multiple clamp trials prior to shunt placement. |
| تدمد: | 1933-0693 0022-3085 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::eae7dbeaa8b6aaa619da7299ac0b35abTest https://doi.org/10.3171/2017.10.jns171644Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....eae7dbeaa8b6aaa619da7299ac0b35ab |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19330693 00223085 |
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