External Lumbar Drainage in Uncontrollable Intracranial Pressure in Adults with Severe Head Injury: A Report of 7 Cases

摘要: The retrospective results of external lumbar drainage in 7 adult patients with severe closed head injury and intracranial pressure (ICP) refractory to aggressive management strategies are presented. All had Glasgow Coma Scale (GCS) scores 8 or less within 24 hours after admission were treated by a staircase protocol including sedation, ventricular drainage, hyperventilation mannitol. In three cases barbiturate drugs an artificially induced hypothermia used. Four required surgical evacuation mass lesions. Three made good functional recovery, 2 severely disabled died. none the clinical signs cerebral herniation occurred. We recommend additional adults unresponsive agressive ICP control open basilar cisterns absent focal lesions on computerized-tomography scan before drainage.