The Benefits and Feasibility of External Lumbar Cerebrospinal Fluid Drainage for Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage: Meta-Analysis and Trial Sequential Analysis

Lee, Cheol Young; Jang, Kyoung Min; Wui, Seong Hyun; Park, Seung Won

doi:10.1016/j.wneu.2022.08.044

Cited by 7 publications

(1 citation statement)

References 34 publications

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“…In pursuit of more dependent areas of CSF drainage, lumbar drains have been hypothesized to remove blood from the subarachnoid space much more effectively, thereby reducing symptomatic vasospasm, cerebral infarction, and mortality [55,56]. One study found that LD may reduce incidence of vasospasm, shorten hospital stay, and possibly improve patient outcomes following aSAH [57].…”

Section: Csf Diversionmentioning

confidence: 99%

Prevention of Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage – Expert Consensus and Summary of Existing Evidence

Miller,

Thappa,

Bahagat

et al. 2024

Preprint

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The 2023 International Subarachnoid Hemorrhage Conference identified a need to provide an up-to-date review on prevention methods for delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage and highlight areas for future research. A PubMed search was conducted for key factors contributing to development of delayed cerebral ischemia: anesthetics, antithrombotics, CSF diversion, and hemodynamic and endovascular management. Over 100 published articles were analyzed. It was found that there is still a need for prospective studies analyzing the best methods for anesthetics and antithrombotics, though inhaled anesthetics and antiplatelets were found to have some advantages. Lumbar drains should increasingly be considered the first line of CSF diversion when applicable. Finally, maintenance euvolemia before and during vasospasm is recommended as there is no evidence supporting prophylactic spasmolysis or angioplasty. There is accumulating observational evidence, however, that intra-arterial spasmolysis with refractory DCI might be beneficial in patients not responding to induced hypertension.

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Section: Csf Diversionmentioning

confidence: 99%